Upload
vobao
View
221
Download
3
Embed Size (px)
Citation preview
Identifier:
SOP-WBOT
Feb 2013
Revision:
0
Effective Date:
1 April 2013
STANDARD OPERATING PROCEDURES
District Health Information System
(DHIS) AGGREGATED Data Management
for
NON-FACILITY HEALTH PROGRAMS
Collection, Entry Validation and Dissemination:
1. Ward Based Outreach Teams (WBOT)
2. Integrated School Health Program (ISHP)
3. Environmental Health (EH)
4. Emergency Medical Services (EMS)
Draft: 6 Feb 2013
These materials have been developed in terms of Service Level Agreement between the National Department of Health and HISP
Department of Health
Page 2 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
LIST OF ABBREVIATIONS
DG Director-General
DBE Department of Basic Education
DHIS District Health Information System
DHMIS District Health Management Information System
DoH Department of Health
DSD Department of Social Development
DQ Data Quality
EH Environmental Health
EMIS Education Management Information System
EMS Emergency Medical Services
EMS PRF EMS Patient Report Form
HIS Health Information System
ISHP Integrated School Health Program
HOD Head of Department
ICT Information and Communication Technology
IT Information Technology
M&E Monitoring and Evaluation
NDoH National Department of Health
NHISSA National Health Information Systems Committee of South Africa
NIDS National Indicator Data Set
NDSA National Service Delivery Agreement
PHC Primary Health Care
PIDS Provincial Indicator Data Set
PQRS Provincial Quarterly Reporting System
QRS Quarterly Reporting System
SOP Standard Operating Procedure
WBOT Ward Based Outreach Teams
Department of Health
Page 3 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
DEFINITIONS
TERMINOLOGY OPERATIONAL DEFINITION
Accuracy
Also known as validity. Data is measured against a referenced source and found to be correct. Accurate data minimize error (e.g. transcription error) to a point of being negligible
Completeness Data are present and usable and represent the complete list of eligible sources and not just a fraction of it
Confidentiality Assurance that data will not be disclosed inappropriately and treated with appropriate levels of security
Data Raw, unprocessed numbers
Data collation
The process where data for a data element from various service points are added together. It is very important to ensure that during this process the responsible person adds the data correctly to avoid arithmetic errors
Data input forms
This refers to the final form which will be used to enter the data into the relevant database
Data sign off
Data sign off refers to the process where the person with the required authority agree to the correctness and validity of the data and commits him or herself to submit data in accordance with data flow guidelines
Indicator A quantitative or qualitative variable that provides a simple and reliable measurement of one aspect of performance, achievement or change in a program or project
Information Processed or analysed data that adds context through relationships between data to allow for interpretation and use
Timeliness Data and information is available on time for meeting budgeting, monitoring, decision making and reporting requirements
Users of data Stakeholders who are authorised to access and use data in DHIS for monitoring, evaluation, research and reporting purposes
Quintiles 1 to 5
Classifying Schools -1 to 5.
Quintile 1 being the poorest school. The poorest schools in Quintile 1 receive a greater allocation per learner than those in Quintile 2. In 2007, the Minister identified Quintile 1 and 2 schools as no-fee schools. In order to rank schools into Quintiles, each school has to be given a school poverty score. The score should be based on the relative poverty of the community around the school, looking at (1) Income (2) dependency ratio (or unemployment rate), (3) level of education of the community (or literacy rate)
The national data source used to determine the poverty score for schools is not able to analyse spatial areas smaller than wards. As such it is not sensitive enough to recognise neighbourhoods of poverty within a larger community. Poor schools in close proximity to better off suburbs will be prejudiced by the wealth of their neighbours and may be ranked in a higher quintile than is justified by their learner demographics
Department of Health
Page 4 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
LIST OF ABBREVIATIONS ............................................................................................. 2
DEFINITIONS .................................................................................................................. 3
1. Introduction ............................................................................................................. 6
1.1 Purpose ......................................................................................................................... 6
1.2 Scope ............................................................................................................................. 6
1.3 Training .......................................................................................................................... 6
1.4 Background .................................................................................................................... 6
1.5 Principles ....................................................................................................................... 7
1.6 Data Tools for AGGREGATED monthly DHIS data management .................................. 9
1.7 Reference Documents ................................................................................................... 9
1.7.1 General documents applicable to all health programs and services ......................... 9
1.7.2 WBOT-specific documents .................................................................................... 10
1.7.3 ISHP-specific documents and software .................................................................. 10
1.7.4 EH-specific documents .......................................................................................... 10
1.7.5 EMS-specific documents ....................................................................................... 10
2. DATA/INFORMATION MANAGEMENT and FLOW ............................................. 11
2.1 DHMIS Responsibilities and Procedures ...................................................................... 12
2.1.1 Health Care Provider = Data Collector ................................................................... 12
2.1.2 Deputy Manager’s DHMIS Responsibilities and Procedures .................................. 13
2.1.3 Facility / Program Manager’s DHMIS Responsibilities and Procedures .................. 14
2.1.4 Data Capturer’s Responsibilities and Procedures .................................................. 16
3. Entering monthly aggregated data for NON-FACILITY health programs .............. 18
3.1 Data Entry and Entry Validation ................................................................................... 18
3.2 Post Entry Data Validation (Data Quality Checks) ........................................................ 21
3.3 Export of data ............................................................................................................... 24
3.3.1 Export to next level ................................................................................................ 24
3.3.2 Export to Data Mart ................................................................................................ 25
3.4 Generating Reports ...................................................................................................... 26
3.5 Pivot Tables ................................................................................................................. 28
4. NON-FACILITY Health Program- Specific Annexures .......................................... 29
4.1 WBOT .......................................................................................................................... 29
4.1.1 WBOT Data Elements (extracted from DHIS Jan 2013) ......................................... 29
4.1.2 WBOT Indicators (extracted from DHIS Jan 2013)................................................. 31
4.1.3 WBOT Validation Rules (extracted from DHIS Jan 2013) ...................................... 33
Department of Health
Page 5 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
4.1.4 WBOT Tools for routine aggregated monthly DHIS data management .................. 34
4.1.5 PHC WBOT Monthly DHIS Data Input Form (DHIS auto-generated) ..................... 37
4.2 Integrated School Health Program (ISHP) .................................................................... 38
4.2.1 ISHP Data Elements (extracted from DHIS Jan 2012) ........................................... 38
4.2.2 ISHP NIDS Indicators (extracted from DHIS Jan 2012).......................................... 42
4.2.3 ISHP Data Tools .................................................................................................... 44
4.3 Environmental Health Program (EH) ............................................................................ 48
4.3.1 EH Data Elements (extracted from DHIS Jan 2012) .............................................. 48
4.3.2 EH Indicators ......................................................................................................... 50
4.3.3 EH Validation Rules (extracted from DHIS Jan 2012) ............................................ 52
4.3.4 EH Data Tools (examples) ..................................................................................... 53
4.4 Emergency Medical Services Program (EMS) .............................................................. 59
4.4.1 EMS Data Elements (extracted from DHIS Jan 2012) ............................................ 59
4.4.2 EMS Indicators (extracted from DHIS Jan 2012) ................................................... 61
4.4.3 EMS Data Tools .................................................................................................... 62
4.5 Maintain the Organisational Hierarchy of NON-FACILITY DHIS data files .................... 65
4.5.1 Organisational Hierarchy Integrated School Health Program (ISHP) data file ........ 65
4.5.2 Organisational Hierarchy Environmental Health (EH) data file ............................... 65
4.5.3 Organisational Hierarchy Emergency Medical Services (EMS) data file/set ........... 65
4.5.4 Organisational Hierarchy – Ward Based Outreach Team (WBOT) data file ........... 65
4.5.5 The PHC WBOT Household Profile Data File ........................................................ 68
4.5.6 Adding Local Data Elements and Indicators .......................................................... 69
Department of Health
Page 6 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
1. Introduction
1.1 Purpose
This document provides Standard Operating Procedures (SOPs) to ensure appropriate, standardised and effective data and information management for monthly aggregated NON-FACILITY Health Programs. It also provides guidelines for:
Standard DHIS data capturing, validation and data flow procedures
Maintaining and expanding the Organisational Hierarchy in the DHIS Data File in a standardised
manner
NON-FACILITY Health Programs include the following:
1) PHC Ward Based Outreach Teams (WBOT)
2) Integrated School Health Programs (ISHP) services
3) Environmental Health (EH)
4) Emergency Medical Services (EMS)
These SOPS focus on general principles applicable to management of all the NON-FACILITY Health Programs and specifics in terms of each program will be indicated throughout the manual.
1.2 Scope
These National Department of Health (NDoH) SOPS are mandatory and shall be implemented by all employees and contractors when engaging in health information related activities in the Department of Health (DoH) facilities. The SOPs must be used in conjunction with the following:
DHMIS Policy 2011
National Indicator Dataset (NIDS)
Reference Documents listed in Section 3
Please note that these SOPs do not cover pilot projects
1.3 Training
The Health Program Managers and Facility Managers must ensure that where relevant team members who follow these procedures understand these SOPS understand the objectives and other inter-related activities.
Each team member involved in data collection, validation capturing, dissemination and use must sign that (s)he has studied and understand these SOPs.
1.4 Background
In terms of the National Health Act (Act 61 of 2003) the National Department of Health (NDoH) is required to facilitate and coordinate the establishment, implementation and maintenance of health information systems at all levels. The District Health Management Information System (DHMIS) Policy 2011 defines the requirements and expectations to provide comprehensive, timely, reliable and good quality routine evidence for tracking and improving health service delivery. The strategic objectives of the policy are to strengthen monitoring and evaluation (M&E) through standardization of data management activities and to clarify the main roles and responsibilities at each level for each category of staff to optimize completeness, quality, use, ownership, security and integrity of data.
Department of Health
Page 7 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
PHC Ward Based Outreach Team services - Central to the PHC Re-engineering Strategy is a
cadre of Community Health Workers (CHW) organised into approximately 5,500 WBOTs. Each of
these teams, consisting of 6 community health workers (CHWs), provides outreach services to
around 1500 households with a ratio of 250 households per CHW and each team is linked to one
PHC facility, called the team’s parent facility.
Integrated School Health Program (ISHP) – As reflected in the National Service Delivery
Agreement (NSDA) strengthening of ISHP services a national Primary Health Care (PHC) Re-
engineering priority. It is also an important component of the Department of Basic Education
(DBE) Care and Support for Teaching and Learning framework.
Environmental Health Services – EH services include water quality monitoring, health
surveillance of premises, port health, and control of hazardous substances, waste management
and chemical safety.
Emergency Medical Services - EMS is recognised as a key component within the health care
delivery system. They are often an entry point into health system services when people are under
life-threatening circumstances. EMS comprises of various elements such as Emergency Care
practitioners, Emergency Physicians, specialised vehicles and equipment, computerised call
centres with computerised communication centres and training.
In 2000 the District Health Information System (DHIS) was adopted as the official South African routine health information system for managing aggregated routine health service based information. Modules NON-FACILITY Health Programs were implemented in some provinces but a standardised National Database will be implemented for each in April 2013.
The national aim is to have computers and competent data capturers at each facility in an incremental manner but, until all facilities are computerised, well managed and monitored paper-based data collection, collation and dissemination systems must be maintained in the most effective and efficient way.
1.5 Principles
The following principles should be kept in mind when these SOPS are implemented:
1. These SOPS are meant for managing routine aggregated DHIS data and NOT for individual
records for which SOPS will be published at a later stage
2. The DHIS contains population-based data (for example population estimates from Statistics
South Africa) and school data (for example schools and number of learners imported from the
Education Management Information System (EMIS) of the DBE) which serves as denominators
for some of the NIDS indicators
3. Data and information must be used at all levels for planning and monitoring against data quality
and health program targets
4. Data collection: Routine aggregated NON-FACILITY Health Program data to be captured into
the DHIS are collected by means of Standardised Tick Registers. The cover page of each Tick
Register should have space for the following:
Team / practitioner name and where applicable parent health facility name (as in DHIS), year
and register number (Tick Register number starts on 1 April and ends on 31 March of the
following year )
Start date of register
End date of register
Register pages must be numbered
Department of Health
Page 8 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
5. Data tools and processes for NON-FACILITY services must be managed in the same manner
as those for fixed facilities.
6. Data capturing, -validation and -feedback: NON-FACILITY data will be captured by the same
designated data capturer capturing aggregated health facility data at:
Facility level where resources are available
Sub-district level where facility level capturing is not available
7. Information Management in terms of data flow, monitoring, mentoring, training and DQ feedback
is the responsibility of Information Officers/Managers at sub-district, district, provincial and
national levels. The following are crucial for monitoring and optimising data quality:
Standardised management of Organisational Unit levels, types and ‘owners’
Standardised activation of relevant data elements at capturing level
Standardised use of 0 (zero) reporting at data collection and capturing levels
Audit readiness similar to health facilities
8. All records, data collection and collation tools must be stored in a secure facility on a daily basis
9. Non-health information staff responsibilities for each NON-FACILITY Health program and the
OrgUnit level for which the program’s data is captured are tabled below
10. Materials, equipment and staff – Facility and District Managers are responsible to ensure that
sufficient stationary, equipment and staff are available to meet responsibilities at each level.
Table 1: Responsibilities – aggregated data management
NON-FACILITY Health Program
Health service
providers = data
collectors
Collection level
validation & summary
Pre-capturing validation
Monthly feedback on data quality
and program progress
OrgUnit Level for Data Entry
WBOT CHWs CHWs &
WBOT Team Leader
Parent Facility Manager
WBOT Program Manager
(all levels)
OrgUnit 7
ISHP School Health Professional
Nurses
School Health Nurses
Parent Facility Manager
ISHP Program Manager
(all levels)
OrgUnit 5
EH Environmental
Health Practitioners
EH Practitioners
EH Program Manager
EH Program Manager
(all levels
OrgUnit 5
EMS
EMS Practitioners
Control Centres
Shift Manager EMS Program
Manager
EMS Program Manager
(all Levels)
OrgUnit 5
Department of Health
Page 9 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
1.6 Data Tools for AGGREGATED monthly DHIS data management
As stated before, individual patient / client records are excluded from these SOPS
Table 2: Tools – aggregated data management
Program Data collection Collation: Sub-totals
Collation: Monthly DHIS Data Input forms
(DHIS auto-generated)
PHC WBOT
CHW Household visit Tick Sheet
CHW Household Visit Monthly Summary form (CHW)
Outreach Team Monthly Summary form (Team Leader)
PHC WBOT Monthly DHIS Data Input Form
(Per WBOT)
ISHP ISHP Tick Sheet (all phases)
ISHP Summary Report Form ISHP Monthly DHIS Data Input Form
(Per School)
EH Daily Register MUNICIPAL EHO
Daily Register PROVINCIAL EHO
Daily Register PORT HEALTH EHO
No sub-total forms are used
1.Monthly Data Input form Municipal Health
2.Quarterly Data Input form Municipal Health
3.Monthly Data Input form Provincial Health
4.Quarterly Data Input form Provincial Health
5.Monthly Data Input form Port Health
6.Quarterly Data Input form Port Health
EMS Call Centre No sub-total forms are used EMS Monthly DHIS Data Input Form
(Per EMS station)
1.7 Reference Documents
Individuals using these procedures should become familiar with the following general and health program specific documents:
1.7.1 General documents applicable to all health programs and services
1) DHMIS Policy, National Department of Health, 2011.
2) National Health Act (Act 61 of 2003): Commencement Section 53 of the National Health Act, 2003.
3) PHC Supervisory Manual, National Department of Health, October 2009
4) Promotion of Access to Information Act (Act 2 of 2000): GN 585, Government Gazette 26332, 14 May 2004.
5) Public Audit Act of 2004 (Act 25 of 2004): Government Gazette Vol 474, Cape Town, 20 December 2004 No. 27121.
6) Public Finance Management Act (Act 1 of 1999): Public Finance Management Amendment Act (Act No. 29 of 1999).
7) Statistics Act (Act 6 of 1999): Government Gazette Vol. 406, Cape Town 21 April 1999. No. 19957.
8) Treasury Regulations: Government Gazette, Vol. 500, Pretoria, 20 February 2008, No 29644.
9) Health National Service Delivery Agreement (NSDA) 2011
Department of Health
Page 10 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
1.7.2 WBOT-specific documents
1) Provincial Guidelines Implementation PHC 3 Streams Overview
2) PHC Re-engineering Narrative
3) Community Health Worker Training Implementation Plan
1.7.3 ISHP-specific documents and software
1) Education Management Information System (EMIS)
2) Integrated School Health Policy
3) ISHP Monitoring and Evaluation
1.7.4 EH-specific documents
1) International Health Regulations
2) (Updated) SUPPLEMENTARY REGULATIONS MADE UNDER THE
INTERNATIONAL HEALTH REGULATIONS ACT, 1974 (ACT NO. 28 OF 1974)
1.7.5 EMS-specific documents
Department of Health
Page 11 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
2. DATA/INFORMATION MANAGEMENT and FLOW
This data flow diagram provides the timelines to ensure that the 45 day deadlines for routine data submission (for all health programs) to NDoH is met.
NATIONAL LEVEL
MONTHLY 50 days after reporting period
National import, validation & saving on server completed
Feedback 60 days after reporting period to provinces
PROVINCIAL LEVEL
MONTHLY 45 days after reporting period
Provincial import, validation & export completed
Feedback in 5 days to district level
DISTRICT LEVEL
MONTHLY 30th : District level import, validation & export completed
Feedback in 5 days down to sub-district level
SUB-DISTRICT LEVEL
MONTHLY 20th : Sub-district level capturing, import, validation & export completed
Feedback in 5 days down to facility level
FACILITY LEVEL DAILY
1. Collect data during service provision (Tick Sheets / Registers)
2. Validate data
3. Calculate sub-totals
4. Capture data (selected facilities)
WEEKLY
• Interim aggregation & validation
MONTHLY (data from 1st to last day of reporting month)
•1st Validated data collection level (sub-total) summaries complete
•2nd Validated Monthly Input Summary to manager
•5th :Validated Monthly Input Summary data capturer
•10th Facility level capturing , validation and export to sub-district level completed
•Feedback in 5 days to data collectors = health care providers
Department of Health
Page 12 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
2.1 DHMIS Responsibilities and Procedures
2.1.1 Health Care Provider = Data Collector
Health care providers (nurses, doctors, EMS and EH practitioners) are responsible and accountable for ensuring high quality data in household and individual patient records and on their own routine data collection and collation tools.
Step Action
1 RECORDING OF DATA ON DATA COLLECTION TOOLS:
On a daily basis the health service provider is responsible and accountable for the following:
1.1 Record data in individual patient/client records (for local use and therefore not included in these routine health information management SOPS). See table 2 for list of individual records used for each NON-FACILITY program
1.2 Record required data in line with the national definitions in the standardised Tick Sheets / Registers during or directly after each visit / service provided. See table 1 and 2 for list of data collectors and tools for each NON-FACILITY program (Annexure 4)
1.3 Indicate the file number / patient number (where relevant) clearly on the standardised Tick Sheets / Registers for follow-up and auditing purposes
1.4 Double check that all the correct data elements in the correct columns were ticked for each visit / service provided
1.5 Maintain confidentiality of all data / information
1.6 File and store individual client records, Tick Sheets / Registers and Summary forms in the dedicated locked facility
2 COLLATION OF DATA ON TICK SHEET / REGISTER
On a weekly and/or monthly basis the health service provider is responsible and accountable for the following:
2.3
Complete and sign Interim (weekly, monthly, ‘when page is full’, for each school) summary forms and submit to the delegated manager on the 1st day of each month. See table 2 for list of individual Sub-total summary tools used for each NON-FACILITY program (Annexure 4)
It is essential that all people write clearly and legibly on all data collection tools
Department of Health
Page 13 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Step Action
NO BLANKS should be left on the monthly summary form
2.1.2 Deputy Manager’s DHMIS Responsibilities and Procedures
Some programs have Deputy Managers called Team Leaders (WBOT), Shift Supervisors (EMS) and various other terms.
‘Deputy Managers’ are responsible for managing respective teams and to collaborate with the linked parent health care Facility Manager and/or Health Program Manager to ensure effective NON-FACILITY services and good quality data in the DHIS.
Step Action
3 COLLATION OF DATA ON THE MONTHLY DHIS (auto-generated) INPUT FORMS
3.1 Capture the total for each health care provider / team member a Sub-total Monthly Summary Form (Table 1 and Annexure 4)
3.2 Count the number of referrals and other management related data (which doesn’t appear on Tick Sheets/Registers) and capture total on the Sub-total Monthly Summary Form
3.3 Calculate and sign clearly
3.4 Validate and transcribe the monthly totals for each team onto the Monthly DHIS Data Input Form (one auto-generated form per team) and sign (Table 1 and Annexure 4)
3.5 Submit the Monthly DHIS Data Input Form to the parent facility (or other dedicated) manager for verification and signature on 2nd of each month and file a copy in the Monthly DHIS Data Input Form file
3.6 Ensure training of team members on data elements, data quality assessment and data use
Ensure that all new team members are orientated on the health information management system
3.7 Oversee, lead and support effective and efficient data collection, management and use on:
Visits and care / health services provided
Work days and supervision visits
Stock and equipment
3.7 Provide monthly feedback to team members with regard to:
Data quality – timeliness, completeness and accuracy of data
Program-related indicators highlighting good performance and service delivery
shortcomings
Department of Health
Page 14 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
3.8 Analyse, interpret and use information for remedial interventions to optimise patient care and health care system performance
Develop action plans in collaboration with team members for indicators that reflect poor performance
2.1.3 Facility / Program Manager’s DHMIS Responsibilities and Procedures
If data submitted for capturing into the DHIS is of poor quality, evidence-based management decisions are compromised at all levels.
Where NON-FACILITY health care services are provided as outreach services, the Facility
Manager is responsible and accountable for the quality of the outreach service data (for example
WBOT and ISHP)
Where NON-FACILITY health care services are provided by teams not directly linked to health
facilities, the lowest level Program Manager/Coordinator is responsible and accountable for the
quality of health program data (for example EH and EMS)
These responsibilities focus on the management of high quality information that must be used to:
optimise patient care and/or community services
optimise public health and the health status of the population
optimise performance of health programs and the healthcare system
improve data quality
monitor, evaluate and report on performance against all legislated plans in the health sector
The health information management responsibilities of Facility Managers / Program Managers/Coordinators are similar for all health programs.
Step Action
1
Provide sufficient resources for routine health information management:
Stationery such as pens, rulers, carbon paper, calculators and staplers
Filing cabinets, files and an effective filing system
Telephones and fax machines
Up-to-date pivot tables, graphs and reports on data quality and program
performance
Definitions of data elements and indicators
Data collection tools (Tick Register, standardised registers, summary forms and
Data Input forms
Mobilise for further resources (staff, hardware and software, email and internet connections)
2 Include data management, monitoring and reporting in performance contracts and job descriptions of all managers, team leaders and health care providers
3
Ensure training on data elements, data quality assessment and data use for all staff responsible for data collection and collation and who manage service points
Ensure that all new staff are orientated on the health information management system
Department of Health
Page 15 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Step Action
4
Oversee, lead and support effective and efficient data collection, management and use on:
Health visits and care/interventions provided
Work days and supervision visits
Stock and equipment
5
Optimise DHIS data quality and use by means of:
Weekly Spot checks on:
o Individual records by means of record reviews (10 records per month)
o Verification that data in Tick Sheets / Registers and on summary forms correlate
o Filing practices for records and data collection tools as required for data verification
and audits
Keep dated and signed records on spot checks done
Keep hard copies of data collection tools for a minimum of three (3) years
Establish an information committee/team for the facility / program to discuss data before
it is sent to the next level, assess data quality and promote an information culture in the
facility
Validate data on monthly DHIS Monthly Data Input Forms
Submit DHIS Monthly Data Input Forms for capturing on the 7th of each month
Ensure that data quality report and pivot table of raw data is received from data capturer
Follow up on feedback from the data capturer and make corrections. If changes to the
data are required it should be made on all the sheets to indicate that the totals have
changed. Draw a line through the incorrect value, write in the new value. These changes
are to be initialled and dated. No correction fluid is to be used. Ensure the entire data trail
back to the initial collection point is corrected
Ensure that the validation rules that were violated are corrected or commented on and
that feedback on violations are given to the sub-district/sub-structure/district office
Ensure that outliers are commented on
Ensure that updated data quality reports and pivot table of raw data is received from the
data capturer after corrections were made in the DHIS
Submit corrected signed-off Data Input form to the data capturer and ensure that a
duplicate is filed in the DHIS Monthly Input Form folder
7
Provide monthly feedback to Team Leaders and health care providers with regard to:
Data quality – timeliness, completeness and accuracy of data
Program-related indicators highlighting good performance and service delivery
shortcomings
8
Analyse, interpret and use information for remedial interventions to optimise patient care and facility / program performance
Develop action plans in collaboration with Team Leaders and health care providers for indicators that reflect poor performance
10 Ensure that facilities and programs are ready for an audit at all times
Department of Health
Page 16 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
2.1.4 Data Capturer’s Responsibilities and Procedures
Data capturers are responsible for capturing data and then forwarding the data to the next level. These responsibilities are similar for all health programs and all levels at which data is captured.
Data capturers must spend 100% of their work time on the data-related responsibilities stipulated below (integrated for all health programs)
Step Action
THE DATA CAPTURER IS ACCOUNTABLE FOR THE FOLLOWING IN TERMS OF AGGREGATED
MONTHLY DHIS DATA FOR ALL HEALTH PROGRAMS:
1 CAPTURING OF AGGREGATED MONTHLY DATA INTO DHIS (for all facility and NON-FACILITY) Health Programs
2.1
Obtain validated Data Input forms from the facility manager on all data sets on the 7th of each month
Conduct a rapid data quality assessment of data on DHIS Monthly Data Input forms –
must be 100% complete and should contain no gaps or outliers without comments
Capture monthly data into the DHIS
Indicate date of capturing on each monthly data input form and sign
Run Min/Max range violations, Absolute validation and Statistical Validation reports on
data
Run Standard Reports on data for outstanding input forms, routine raw data reports and
ad hoc reports
Follow up any discrepancies found in data with facility manager and keep record of
A facility is ready for an audit when:
All internal policies and procedure documents are available and are implemented
Each patient has only one patient folder/clinical record and file is available in the facility at all times (proper filing system)
Information recorded on data collection tool (Tick Register, standard register or patient based software application) are consistent with patient folder and supporting documentation
Where applicable all patient records are captured on electronic databases, e.g.ETR.net, TIER.net,
Information recorded in DHIS is consistent with data input forms
All data input forms applicable to the facility have data collected for and are captured in the DHIS
All data collection tools used for collection of data by institution have been reviewed for quality and have been signed off by the health care provider who collected the data
All registers are reviewed for quality and have been signed off by the facility manager
All validation errors are corrected or explained
All outliers are explained
Processing of data updates is done correctly
All sign off forms are properly completed and signed off by the facility manager
Department of Health
Page 17 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Step Action
follow up date and person
Verify that facility manager made the appropriate corrections on the data input form. A
line should be drawn through the incorrect value and the new value should be written.
Changes are to be initialled and dated. No correction fluid is to be used. The entire data
trail back to the initial service point must be corrected
On receiving feedback from the facility manager, correct the values in DHIS and send
updated reports and pivot tables to the facility manager to sign off the data
Export data to Data Mart and refresh pivot tables – compare data in pivot tables with that
on summary forms. The following is crucial in this process:
o Save existing standard pivot tables with a different name (for example add date)
before exporting to Data Mart
o Empty the Data Mart, do a full export to Data Mart and then refresh the standard
pivot tables
Obtain sign-off from the Facility Manager of the data
Attach following DHIS reports to sign-off form as proof of data quality:
o Data entry validation report
o Min/Max violations
o Outstanding input forms
o Pivot table of raw data
Export data on all NIDS data elements and send export file to sub-district or district level
(as relevant) before the 10th of each month
Ensure that back-ups are made every time data is changed
File records needed to meet monitoring and audit requirements and store safely in a
locked facility
Department of Health
Page 18 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
3. Entering monthly aggregated data for NON-FACILITY health programs
Data capturers must provide comprehensive and integrated data capturing services and are expected to capture data for all health programs. NON-FACILITY Health Program data is captured by the same data capturers entering health facility data. This data can be captured into the DHIS at facility, at sub-district or district level, depending on resources and processes in place for capturing (ALL) health program data.
The process for capturing monthly aggregated DHIS data is the same for all NON-FACILITY health programs in their respective data files displayed below.
Health Program
WBOT ISHP EH EMS
DHIS Data Base /
Data File
DHIS_#ZA_NDOH_WBOT.MDB
DHIS_#ZA_NDOH_ISHP.MDB
DHIS_#ZA_NDOH_EHP.MDB
Provincial data file e.g.
DHIS_#ZA_ECAPE
The WBOT data file will be used to illustrate the data capturing process and program-specific aspects will be specified where relevant.
.
3.1 Data Entry and Entry Validation
Desktop – Use DHIS14 Start Up icon to open the DHIS database
Control Centre – Click on Switch data file
Data cannot be entered or edited unless logged in with a user name
Department of Health
Page 19 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
For entering PHC Ward Based Outreach Team data, select
DHIS_#ZA_NDOH_WBOT and click OK
For capturing School Health data, select
DHIS_#ZA_NDOH_ISHP and click OK
For capturing Environmental Health data select
DHIS_ZA_NDOH_EHS and click OK
For entering EMS data select your provincial data file and click OK.
Control Centre – Click on Data – Entry/Edit
Select the Data Set you want to enter data for – we will use PHC WBOT Data (PHC Ward
(1) Select the Data set for which you want to capture data
(2) Select period /month for which you want to enter data for example Nov-12
(3) Select the OrgUnit for which you want to enter data for example:
Province = nw North West Province
District = nw Dr Ruth Segomotsi Mompati
Sub-district = nw Naledi LM
Ward = nw Naledi Ward 4
Facility = nw Huhudi CHC
Team = Huhudi CHC Outreach Team 1 – W004
If the WBOT for which you want to enter
data does not display in the OrgUnit
Hierarchy, ask your information officer to
assist. See annexure 1 for explanation.
To show or hide OrgUnits, click the ‘+’ and ‘–‘.
Department of Health
Page 20 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
The following Data Entry screen will appear
Enter the data from the Monthly Input form into the Entry box for each of the elements. The sequence of the data elements on the Monthly Input form and those on the computer screen are the same, but it is good data capturing practice to make sure that each Entry is for the correct data element
Validation of data during the data capturing process
The DHIS software has several functions to assist data capturers to optimise data quality:
1. Min/max values / entry out of range – the
Min and Max values displaying the values for
each element (values with which the
database was developed), will be auto-
calculated after 3 months of data entry using
the values captured for each individual
facility
2. It is good practice to reset Min/max values
for each WBOT team with the Team Leader
when entering data for the first time
Department of Health
Page 21 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
When a value outside the min/max range is
captured a graph indicating the trend lines
appears to flag a potential data quality
problem.
After verifying the data by means of checking the value on the Input form or phoning the Parent Facility Manager, select the most suitable alternative from the action list next to the graph.
3. Colour coding of entry cells – when a
potentially incorrect value is captured, the
cell colour indicates that the data in that
Entry cell may be incorrect and should be
verified
See colour code explanation in the lower left corner of the Data Entry screens.
4. Click in the Check box if you want to
check or investigate a value at a later
stage. This will indicate that the value may
not be correct
5. A comment should be added to indicate
that a value might not be correct. You can
choose a Comment from the drop-down list
or type a comment free text.
Comments are useful as they can inform
the next person that needs to interpret the
data long after the data has been entered.
3.2 Post Entry Data Validation (Data Quality Checks)
Data validation while in the data entry screen (after completing data entry)
After data entry has been completed, the system prompts the user to run validation rules. Good data management dictates that these should be run routinely after the data for each reporting unit has been entered. Any violations found must be addressed immediately.
Department of Health
Page 22 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
After entering and saving the data in the data entry screen you need to press the Validate button at the top of the screen
The programme runs a quick validation check of the data entered and produces a report that describes any errors in the data.
Close, follow up and correct input errors for which corrections can be obtained immediately.
If you need to share these results you can copy the report to clipboard and save.
When finished click on Control Centre button in right top corner of screen
Data Validation from Control Centre
Further validation of the data is found in the Control Centre – clicking on Data Quality .
1. Routine ‘Check it’ data allows you to view all the
data entries that have been marked for follow up
Select OrgUnit
Select Data Set
Select Data Element Group
Entries for which check boxes were clicked displays – follow up and verify
Department of Health
Page 23 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
2. Data Validation:
National absolute and/or statistical validation rules have been designed in order to identify data errors for correction
Run Absolute Validation – select OrgUnits,
Source Level, Data Set, Data Period and click
Run Analysis
Run Statistical Validation
Example of Absolute Validation rule violations
To view the data elements where the violations occurred, click on Show Data Record Detail button
To edit data (after verification with facility) click Open Data Entry Form button
Examples statistical validation rule violations (no statistical validation rules set up in current WBOT data file)
Department of Health
Page 24 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Advanced Quality Checks are for advanced users to :
- Identify gaps and outlier values. You can either identify missing records or outliers.
- Run integrity checks
3.3 Export of data
3.3.1 Export to next level
After entering and validation of data, the data capturer must export the data to the next level
Export to next level
After capturing and validation of data for all the reporting units that submitted data, OR on the d-date for sending data to the next level irrespective whether all units submitted, data must be exported to the next level.
Click on Export / Import button
Select Export to XML/Text
Select the data set you want to export
Browse for OrgUnits to include in the export and select
Select the period
Select months for which records were modified after validation
Click Export Specification button
Department of Health
Page 25 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Select data sets you want to export by moving them from the Available (right column) to left column. Use selection arrows to move items
Data element groups
Data elements
OrgUnit groups
Click on back to Export Criteria button
Click on Export button (bottom right corner)
The export file will by default be stored in the C:\DHIS 14\Transfer folder in a 7Zip format
(R) click on the file you want to export. Click on Send to and select Mail recipient and email to dedicated person at the next level
3.3.2 Export to Data Mart
After data was forwarded to next level data must be exported to the Data Mart from where pivot tables are refreshed (see section 3.5)
Export to Data Mart
After capturing and saving new data, export it to Data Mart.
In the Control Menu choose Export To Data Mart. Then click on Export Data to Data Mart button again and choose Full if it’s the 1st time and Partial export thereafter and set the dates for ideally the
Department of Health
Page 26 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
previous month in case there were adjustments made.
3.4 Generating Reports
Short reports on the data can be generated by clicking on the Control Centre.
The two common reports we will examine will be the
1. Routine Raw Data Report and the
2. Ad Hoc Raw Data Report.
The Routine Raw Data Report:
a) choose the Data Set (eg CHW Outreach Teams) b) Select the Org Unit - district, sub-district or facility you
wish to create a report for (nw Naledi Local Municipality)
If you tick Use Default OrgUnit from Data Entry Form - your drop-down options for select Org Unit described above will have the same OrgUnit tree as in your Data Entry screens
c) The Source level is the reporting Unit d) Set the data period e) You can filter the Org unit group to show just the
reporting Unit.
Department of Health
Page 27 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Select if you want to Include the Min/Max Values or if you want to Include Totals in the report.
Under Outputs you have a variety of choices for the format you want the report in:
MS Word Report
If you select this MS Word Setup screen will open
You can edit the title, margins and layout of the report in Word on this screen.
Click OK
Your Word report will look similar to this.
The Ad-Hoc Raw Data report allows you to extract any raw data and display it in a pivot table. The report is useful if you only want data for a selected few data elements.
Similar steps are followed as above but the ‘Root’ Org Unit is usually at District or Province so that you can pivot at different levels in the data.
Select the data elements you want in your report by highlighting the elements in the Available List and clicking on the Right arrow.
An example of the resulting report.
Department of Health
Page 28 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
3.5 Pivot Tables
Pivot tables are generated when data is exported to the Data Mart. The pivot tables are located in the DHIS root folder or you can access them from the DHIS Control Centre. The following looks very briefly at accessing the PHC Outreach Pivot table.
Pivot tables are saved in Excel files with naming DHIS_$ followed by the province.
Another way of opening the Pivot Table is to click this shortcut on the Control Centre in the DHIS.
A table appears for you to select what Pivots are available.
Click on the table name and the excel pivot table opens.
At the bottom of the screen there are different tabs for different sheets.
The Overview explains the Org unit setup. So you can see all the Outreach teams per clinic
Routine data allows you to examine the data elements and the Indicator Sheet allows you to examine the indicators.
The ‘DE Des’ and ‘Ind Des’ is where you will find the definitions of either Data Elements or Indicators in this Outreach Data File.
4. NON-FACILITY Health Program- Specific Annexures
4.1 WBOT
4.1.1 WBOT Data Elements (extracted from DHIS Jan 2013)
Number Data Element
Name Definition Use and context
IndGroup
Frequency
Collected By
Collection Points
Tools
1 OHH Households in population
Total number of households in the population that should be visited and registered by Ward Based Outreach Teams
Monitors implementation of PHC re-engineering in terms of Ward Based Outreach Teams. Will be auto-calculated when stats SA releases break-downs of 2011 Census data (the Small Area Layer)
PHC WBOT
Yearly StatsSA N/A N/A
2 OHH CHW supervised by team leader
The number of CHWs who are supervised by the Ward Based Outreach Team leader
Team leader should enter this monthly PHC WBOT
Monthly Manager WBOT N/A
3 OHH allocated to team
Number of households allocated to Ward Based Outreach Teams
Each Ward Based Outreach Team is allocated a specific number of households to support
PHC WBOT
Monthly WBOT Household Tick Register WBOT
4 OHH registration visit
Number of initial visits to households by Ward Based Outreach Teams that included completing a household registration form
Each household allocated to Ward Based Outreach Team must be registered during the first household visit by a team member, using the standardised Household Registration form
PHC WBOT
Monthly WBOT Household Tick Register WBOT
5 OHH follow-up visit
Number of households visited by a Ward Based Outreach Team to provide follow-up health care support
Members of the Ward Based Outreach Teams are expected to visit each household for follow-up support each month. At risk households might need to be visited more frequently
PHC WBOT
Monthly WBOT Household Tick Register WBOT
6 OHH visits total Total number of households visited by Ward Based Outreach Teams
This is the sum of registration visits and follow-up visits PHC WBOT
Monthly N/A N/A DHIS calculate
7 OHH supervised visit
Number of Ward Based Outreach Team visits accompanied by a supervisor
Monitors supervision of Ward Based Outreach Team member (Community Health Workers - CHW)
PHC WBOT
Monthly WBOT Household Tick Register WBOT
8 OHH with pregnancy care
PHC outreach household (OHH) visit where care was provided to pregnant women
Do not count individual pregnant women PHC WBOT
Monthly WBOT Household Tick Register WBOT
9 OHH with postnatal care
PHC outreach household (OHH) visit where care was provided to woman and/or newborn baby within 6 days after delivery
Do not count individual postnatal woman PHC WBOT
Monthly WBOT Household Tick Register WBOT
10 OHH with child under 5 years care
Outreach household (OHH) visit where care was provided to child(ren) under 5 years of age
Do not count individual children PHC WBOT
Monthly WBOT Household Tick Register WBOT
Department of Health
Page 30 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Number Data Element
Name Definition Use and context
IndGroup
Frequency
Collected By
Collection Points
Tools
11 OHH with adherence support
Outreach household (OHH) visit where adherence support was provided
Do not count individual clients PHC WBOT
Monthly WBOT Household Tick Register WBOT
12 OHH with home based care
Outreach household (OHH) visit where home based care was provided
Do not count individual clients PHC WBOT
Monthly WBOT Household Tick Register WBOT
13 OHH client refer to facility
Number of clients of all ages referred to health facilities by Ward Based Outreach Teams
Include referrals to all health facilities, including referrals for care provided by special teams like Oral Health or Mental Health
PHC WBOT
Monthly WBOT Household Tick Register WBOT
14 OHH client refer to social services
A client who was referred to social services by a Ward Based Outreach Team (CHW) during a household visit
Monitors referral to social services. Count individual clients
PHC WBOT
Monthly WBOT Household Tick Register WBOT
15 OHH client refer to home based care
A client who was referred to home based care by a Ward Based Outreach Team (CHW) during a household visit
Monitors referral to home based care. Count individual clients
PHC WBOT
Monthly WBOT Household Tick Register WBOT
16 OHH headcount under 5 years
Number of children under 5 years to whom care was provided by Ward Based Outreach Teams
The community health worker (CHW) must enter the total number of children under 5 years of age to whom support was provided in each household visited, on the CHW Household visit form
PHC WBOT
Monthly WBOT Household Tick Register WBOT
17 OHH headcount 5 years and older
Number of clients 5 years and older to whom care was provided by Ward Based Outreach Teams
The community health worker (CHW) must enter the total number of clients 5 years and older to whom support was provided in each household visited, on the CHW Household visit form
PHC WBOT
Monthly WBOT Household Tick Register WBOT
18 OHH headcount total
Total number of outreach clients care for (sum of outreach headcount under 5 years and outreach headcount 5 years and older)
Add the total of the outreach headcount under 5 years and the total of the outreach headcount 5 years and older
PHC WBOT
Monthly N/A N/A DHIS calculate
19 OHH support group
The number of community support groups facilitated by Ward Based Outreach Teams
Count the number of support group meetings facilitated
PHC WBOT
Monthly Manager WBOT N/A
20 OHH campaign The number of community campaigns supported by Ward Based Outreach Teams
Count each campaign once irrespective of number of team members involved
PHC WBOT
Monthly Manager WBOT N/A
21 OHH back-referral form
Outreach household (OHH) client with health facility back referral form
Count individual forms PHC WBOT
Monthly Manager WBOT N/A
Department of Health
Page 31 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
4.1.2 WBOT Indicators (extracted from DHIS Jan 2013)
Nr Indicator Name Type Annualised
Numerator Denominator Definition Use and context IndGroup Freq Level Key
reports
1 OHH registration visit coverage (annualised)
% 1 OHH registration visit
OHH in population
Proportion of households in the target wards covered by Ward Based Outreach Teams
Monitors implementation of the PHC re-engineering strategy
PHC WBOT
Monthly Output
2 OHH follow-up visit rate
% 0 OHH follow-up visit
OHH visits total
Outreach household follow-up visits as proportion of all households visits by Ward Based Outreach Teams
Monitors follow-up visits to registered households. Community health workers are expected to visit each household for follow up support monthly. At risk households need to be visited more frequently
PHC WBOT
Monthly Process/Activity
3 OHH supervised visit rate
% 0 OHH supervised visit
OHH visits total
Outreach household (OHH) visits accompanied by a supervisor as proportion of all household visits by Ward Based Outreach Teams
Monitors supervision of ward based community Health workers
PHC WBOT
Monthly Process/Activity
4 OHH with pregnancy care rate
% 0 OHH with pregnancy care
OHH visits total
Outreach households (OHH) visits during which antenatal care was provided to pregnant women as proportion of households visited by the Ward Based Outreach Team
Monitors households where care was provided to pregnant women, irrespective of the number of pregnant women cared for
PHC WBOT
Monthly Output
5 OHH with postnatal care rate
% 0 OHH with postnatal care
OHH visits total
Outreach households (OHH) with postnatal care provided to a mother and/or neonate within 6 days after delivery as proportion of households visited by the Ward Based Outreach Team
Monitors households where care was provided to postnatal women, irrespective of the number of postnatal women cared for
PHC WBOT
Monthly Output
6 OHH with child under 5 years care rate
% 0 OHH with child under 5 care
OHH visits total
Outreach households (OHH) with basic health care provided to children under 5 years as proportion of households visited by the Ward Based Outreach Team
Monitors households where care was provided to children under 5, irrespective of the number of children under 5 cared for
PHC WBOT
Monthly Output
7 OHH with adherence support rate
% 0 OHH with adherence support
OHH visits total
Outreach households (OHH) with adherence support provided as proportion of households visited by the Ward Based Outreach Team
Monitors households where adherance support was provided, irrespective of the number of clients who received support
PHC WBOT
Monthly Output
8 OHH with home based care rate
% 0 OHH with home based care
OHH visits total
Outreach households (OHH) with home based support provided as proportion of households visited by the Ward Based Outreach Team
Monitors households where homebased care was provided, irrespective of the number of clients who received homebased care
PHC WBOT
Monthly Output
Department of Health
Page 32 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
Nr Indicator Name Type Annualised
Numerator Denominator Definition Use and context IndGroup Freq Level Key
reports
9 OHH back-referral forms rate
% 0 OHH client with back-referral form
OHH client referred to facility
Outreach households (OHH) back referral forms received from PHC facilities as proportion of all households with referrals to PHC facility done by the Ward Based Outreach Team
Monitors back-referrals fron PHC facilities. Each back-referral form is counted
PHC WBOT
Monthly Process/Activity
10 OHH client referred to facility rate
% 0 OHH client refer facility
OHH headcount total
Proportion of outreach household clients referred to health facilities
Monitors referral by Community Health Workers (CHW) to health facilities. Individual clients referred are counted
PHC WBOT
Monthly Process/Activity
NSDA; NSP; WHO
11 OHH client referred to social services rate
% 0 OHH client referred to social services
OHH headcount total
Outreach households (OHH) clients referred to social services as proportion of the total number of clients supported (total headcount) during outreach team visits
Monitors referral by Community Health Workers (CHW) to social services. Individual clients referred are counted
PHC WBOT
Monthly Process/Activity
NSDA; NSP; WHO
12 OHH client referred to home based care rate
% 0 OHH client referred to home based care
OHH headcount total
Outreach households (OHH) clients referred to home based care as proportion of the total number of clients supported (total headcount) during outreach team visits
Monitors referral by Community Health Workers (CHW) to home nased care. Individual clients referred are counted
PHC WBOT
Monthly Process/Activity
NSDA; NSP; WHO
13 OHH registration visit rate
% 0 OHH registration visit
OHH allocated to team
Outreach household (OHH) registration visits as proportion households allocated to Ward Based Outreach Teams
Monitors household registration. Each household allocated to a community health worker must be registered during the first outreach household visit, using the standardised Household Registration form
PHC WBOT
Monthly Output
14
OHH headcount under 5 years coverage (annualised)
% 1 OHH headcount under 5 years
Population under 5 years
Proportion of children under 5 years in population who received care during Ward Based Outreach Team visits
Monitors proportion of population under 5 years attended to during household visits
PHC WBOT
Monthly Output
15
OHH headcount 5 years and older coverage (annualised)
% 1 OHH headcount 5 years and older
Population 5 years and older
Proportion of people 5 years and older in the population who received care during Ward Based Outreach Team visits
Monitors proportion of population 5 years and older attended to during household visits
PHC WBOT
Monthly Output
Department of Health
Page 33 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
4.1.3 WBOT Validation Rules (extracted from DHIS Jan 2013)
1 OHH registration visit must be less than or equal to OHH total visits
2 OHH supervised visit must be less than or equal to OHH total visits
3 OHH with pregnant care must be less than or equal to OHH total visits
4 OHH with postnatal care must be less than or equal to OHH total visits
5 OHH with child under 5 years care must be less than or equal to OHH total visits
6 OHH with adherence support must be less than or equal to OHH total visits
7 OHH with home based care must be less than or equal to OHH total visits
8 OHH client refer to clinic must be less than or equal to OHH headcount total
9 OHH client refer to social services must be less than or equal to OHH headcount total
10 OHH client refer to home based care must be less than or equal to OHH headcount total
4.1.4 WBOT Tools for routine aggregated monthly DHIS data management
4.1.4.1 WBOT Tick Register / Sheet
Department of Health
Page 35 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
4.1.4.2 WBOT sub-total Summary Form
Department of Health
Page 36 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Ward Based Outreach Teams (WBOT)
4.1.4.3 WBOT Monthly Summary Form (Team Leader)
4.1.5 PHC WBOT Monthly DHIS Data Input Form (DHIS auto-generated)
District: ______________________________ Sub-district: ________________________
Health Facility: __________________________ Ward: _______________________________
WBOT Team: ______________________________ Reporting Month: _____________________
SortOrder
DataElement Value Comment
1 OHH follow-up visit
2 OHH supervised visit
3 OHH with pregnancy care
4 OHH with child under 5 years care
5 OHH with adherence support
6 OHH with home based care
7 OHH headcount under 5 years
8 OHH headcount 5 years and older
9 OHH support group
10 OHH campaign
11 OHH back-referral form
12 OHH registration visit
13 OHH visits total
14 OHH allocated to team
15 OHH CHW supervised by team leader
16 OHH with postnatal care
17 OHH headcount total
18 OHH client refer facility
19 OHH client refer social services
20 OHH client refer home based care
Designation Name & Surname (Print clearly) Data Verification
Signature Date
PHC WBOT Team Leader
Parent Facility Manager
Data Capturer (after entry)
4.2 Integrated School Health Program (ISHP)
4.2.1 ISHP Data Elements (extracted from DHIS Jan 2012)
Nr Data Element
Name Type Definition Use and context IndGroup Frequency
Collected By
Collection Points
Tools
1 School Quintile classification
Number
All schools are classified into quintiles by the DBE, with for instance Q1 and Q2 schools being the poorest/no fee schools
Planning and monitoring. Schools including their quintile classification are imported from the Department of Basic Education (DBE) database into the DHIS, or if not available from the provincial/local DBE
School Health
OnChange DoE EMIS N/A
2 School Grade All - learners total
Number The total number of learners in the school
Planning and monitoring. Schools including their quintile classification are imported from the Department of Basic Education (DBE) database into the DHIS, or if not available from the provincial/local DBE
School Health
OnChange DoE EMIS N/A
3 School Grade 1 - learners total
Number Total number of Grade 1 learners in the school
Planning and monitoring. Schools including their quintile classification are imported from the Department of Basic Education (DBE) database into the DHIS, or if not available from the provincial/local DBE
School Health
OnChange DoE EMIS N/A
4 School Grade 4 - learners total
Number The total number of Grade 4 learners in the school
Planning and monitoring. Schools including their quintile classification are imported from the Department of Basic Education (DBE) database into the DHIS, or if not available from the provincial/local DBE
School Health
OnChange DoE EMIS N/A
5 School Grade 8 - learners total
Number The total number of Grade 8 learners in the school
Planning and monitoring. Schools including their quintile classification are imported from the Department of Basic Education (DBE) database into the DHIS, or if not available from the provincial/local DBE
School Health
OnChange DoE EMIS N/A
6 School Grade 10 - learners total
Number The total number of Grade 10 learners in the school
Planning and monitoring. Schools including their quintile classification are imported from the Department of Basic Education (DBE) database into the DHIS, or if not available from the provincial/local DBE
School Health
OnChange DoE EMIS N/A
7 School learners screened - total
Number
The total number of all grade learners in the school screened by a nurse in line with the ISHP service package
This data element is also used to calculate indicators for proportion of schools covered by the School Health Teams
School Health
Monthly N/A N/A DHIS calculate
8 School Grade 1 - learners screened
Number
Number of Grade 1 learners in the school screened by a nurse in line with the ISHP service package
Health Screening include oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education include hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Quintile 1 (Q1) and Quintile 2 (Q2) schools are the poorest / no fees schools. Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
Department of Health
Page 39 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Nr Data Element
Name Type Definition Use and context IndGroup Frequency
Collected By
Collection Points
Tools
9 School Grade 4 - learners screened
Number
Number of Grade 4 learners in the school screened by a nurse in line with the ISHP service package
Health Screening include oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education include hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
10 School Grade 8 - learners screened
Number
Number of Grade 8 learners in the school screened by a nurse in line with the ISHP service package
Health Screening include oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education include hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Quintile 1 (Q1) and Quintile 2 (Q2) schools are the poorest / no fees schools. Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
11 School Grade 10 - learners screened
Number
Number of Grade 10 learners in the school screened by a nurse in line with the ISHP service package
Health Screening include oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education include hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
12 School Grade Other - learners screened
Number
Number of Other Grade learners in the school screened by a nurse in line with the ISHP service package (not in grade 1/4/8/10)
Health Screening include oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education include hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
Department of Health
Page 40 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Nr Data Element
Name Type Definition Use and context IndGroup Frequency
Collected By
Collection Points
Tools
13 School learner underweight
Number
A learner with weight diagnosed below the -2 SD line but above the -3 SD line for the first time
Health Screening include oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education include hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
14 School learner overweight
Number
A learner with weight diagnosed above the -2 SD line for the first time
Health Screening include oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education include hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
15 School learner referred for Oral Health
Number A learner referred for Oral Health issues
Health Screening include oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education include hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
16 School learner referred for Eye Care
Number A learner referred for Eye Care
Health Screening include oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education include hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
Department of Health
Page 41 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Nr Data Element
Name Type Definition Use and context IndGroup Frequency
Collected By
Collection Points
Tools
17
School learner referred for Hearing problems
Number A learner referred for Hearing problems
Health Screening includes oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education includes hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
18
School learner referred for Speech problems
Number A learner referred for Speech problems
Health Screening includes oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunization, oral health, minor ailments. Health education includes hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
19 School learner referred for Suspected TB
Number A learner referred for Suspected TB
Health Screening includes oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunisation, oral health, minor ailments. Health education includes hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
20 School learner immunised
Number A learner given immunisation
Health Screening includes oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunisation, oral health, minor ailments. Health education includes hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
Department of Health
Page 42 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Nr Data Element
Name Type Definition Use and context IndGroup Frequency
Collected By
Collection Points
Tools
21 School learner dewormed
Number A learner given deworming tablets
Health Screening includes oral health, vision, hearing, speech, height and weight, physical assessment, mental health, tuberculosis, chronic illnesses, psychosocial support. On-site services include deworming, immunisation, oral health, minor ailments. Health education includes hand washing, personal and environmental hygiene, nutrition, tuberculosis, road safety, poisoning, know your body, abuse (sexual, physical, emotional). Integrated School Health Package (ISHP) includes health screening, on site services, health education)
School Health
Monthly School Health
School
Tick Register School Health
4.2.2 ISHP NIDS Indicators (extracted from DHIS Jan 2012)
Nr Indicator Name Type Annualised
Numerator Denominator Definition Use and context IndGroup
Freq Level Key
reports
1 School ISHP coverage (annualised)
% 1 Schools with any learner screened
Schools - total Proportion of schools in which the ISHP service package was provided
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
APP; NSDA
2 School learner screening coverage (annualised)
% 1 School learners screened
School learners - total
Proportion of all learners screened by a nurse in line with the ISHP service package
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
APP
3 School Grade 1 screening coverage (annualised)
% 1 School Grade 1 learners screened
School Grade 1 learners - total
Proportion of Grade 1 learners screened by a nurse in line with the ISHP service package
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
APP
4 School Grade 4 screening coverage (annualised)
% 1 School Grade 4 learners screened
School Grade 4 learners - total
Proportion of Grade 4 learners screened by a nurse in line with the ISHP service package
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
5 School Grade 8 screening coverage (annualised)
% 1 School Grade 8 learners screened
School Grade 8 learners - total
Proportion of Grade 8 learners screened by a nurse in line with the ISHP service package
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
APP
6 School Grade 10 screening coverage (annualised)
% 1 School Grade 10 learners screened
School Grade 10 learners - total
Proportion of Grade 10 learners screened by a nurse in line with the ISHP service package
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
7 School learner underweight rate
% 1 School learners underweight
School learners screened - total
Proportion of learners screened by a nurse in line with the ISHP service package diagnosed as underweight (below -2SD but above -3SD)
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
Department of Health
Page 43 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
8 School learner overweight rate
% 1 School learners overweight
School learners screened - total
Proportion of learners screened by a nurse in line with the ISHP service package diagnosed as overweight (above +2SD)
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
9 School learner referred for Oral Health rate
% 1 School learner referred for Oral Health
School learners screened - total
Proportion of learners screened by a nurse in line with the ISHP service package and referred for Oral Health
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
10 School learner referred for Eye Care rate
% 1 School learner referred for Eye Care
School learners screened - total
Proportion of learners screened by a nurse in line with the ISHP service package and referred for Eye Care
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
11 School learner referred for Hearing problems rate
% 1 School learner referred for Hearing problems
School learners screened - total
Proportion of learners screened by a nurse in line with the ISHP service package and referred for Hearing problems
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
12 School learner referred for Speech problems rate
% 1 School learner referred for Speech problems
School learners screened - total
Proportion of learners screened by a nurse in line with the ISHP service package and referred for Speech problems
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
13 School learner referred for Suspected TB rate
% 1 School learner referred for Suspected TB
School learners screened - total
Proportion of learners screened by a nurse in line with the ISHP service package and referred for Suspected TB
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
14 School learner immunised rate
% 1 School learner immunised
School learners screened - total
Proportion of learners screened by a nurse in line with the ISHP service package and given immunisation
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
15 School learner deworming rate
% 1 School learner dewormed
School learners screened - total
Proportion of learners screened by a nurse in line with the ISHP service package and given deworming tablets
Monitors implementation of the Integrated School Health Program (ISHP)
School Health
Monthly
Process/Activity
4.2.3 ISHP Data Tools
Department of Health
Page 45 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.2.3.1 ISHP Tick Sheet / Register (all phases) Each new school visited should be captured on a new page School: EMIS number: Quintile: Sub-district: Date:
Serial nu
mb
er
Learner’s Name and Surname
Gen
de
r: M
or
F
Gra
de
1
Gra
de 4
Gra
de 8
Gra
de 1
0
Oth
er
Gra
des
Unde
r W
eig
ht
Over
Weig
ht
Referred
Imm
uniz
atio
n s
tatu
s
6 y
r T
d g
iven
12 yr
Td g
ive
n
Min
or
aili
nm
en
t
Psycho
-so
cia
l
Dew
orm
ing
Follo
w u
p
Comment and/or Treatment given
Ora
l H
ealth
Vis
ion o
r E
ye
Heari
ng
Speech
Suspe
cte
d T
B
Oth
er
refe
rrals
SHS 7
4.2.3.2 ISHP Sub-total Summary form
ISHP SUMMARY REPORT FORM: DATA ITEMS Unit: Period:
TO
TA
L
1. Number of Q1 and Q2 schools in which the ISHP service package was provided.
2. Number of Grade 1 learners in Q1 and Q2 schools screened by a nurse in line with the ISHP service package
3. Number of Grade 4 learners in Q1 and Q2 schools screened by a nurse in line with the ISHP service package
4. Number of Grade 8 learners in Q1 and Q2 schools screened by a nurse in line with the ISHP service package
5. Number of Grade 10 learners in Q1 and Q2 schools screened by a nurse in line with the ISHP service package
6. Number of Grade 1 learners screened by a nurse in line with the ISHP service package
7. Number of Grade 4 learners screened by a nurse in line with the ISHP service package
8. Number of Grade 8 learners screened by a nurse in line with the ISHP service package
9. Number of Grade 10 learners screened by a nurse in line with the ISHP service package
10. Number of learners screened by a nurse in line with the ISHP service package
11. Grades 1 learners referred for visual problems after screening.
12. Grade 1 learners referred for hearing problems after screening.
13. Learners given 6 year Td immunisation on site
14. Learners given 12 year Td immunisation on site
Completed by: Name: Signature: Date:
SHS 9
Department of Health
Page 48 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.3 Environmental Health Program (EH)
4.3.1 EH Data Elements (extracted from DHIS Jan 2012)
Nr Data Element Name Definition Use and context IndGroup Frequency Collected By
Collection Points
Tools
1 EH Domestic water samples collected
Total number of domestic drinking water samples collected and analysed from a Water Services Authority and Non Water Services Authority (Vessels, Aircrafts, etc) in terms of the standards set out in SANS 241
This should exclude samples collected in outbreaks and for other specific purposes
Environmental Health
Monthly EHP EH sites Tick Register EH
2 EH Domestic water samples compliant
Number of domestic drinking water samples collected and analysed from a Water Services Authority and Non Water Services Authority (Vessels, Aircrafts, etc) in terms of the standards set out in SANS 241
This should exclude samples collected in outbreaks and for other specific purposes
Environmental Health
Monthly EHP EH sites Tick Register EH
3 EH Food poisoning reported new
Number of new food poisoning cases reported to EHP officers
Monitors food safety Environmental Health
Monthly EHP EH sites Tick Register EH
4 EH Food sample bacteriological analysis
Total number of food samples taken for bacteriological analysis according to regulations promulgated in terms of the Foodstuffs, Cosmetics and Disinfectants Act, Act 54 0f 1972
This includes milk samples taken for bacteriological analysis
Environmental Health
Monthly EHP EH sites Tick Register EH
5 EH Food sample bacteriologically compliant
Number of food samples bacteriologically analysed that complied to the Foodstuffs, Cosmetics and Disinfectants Act, Act 54 0f 1972
This includes milk samples taken for bacteriological analysis
Environmental Health
Monthly EHP EH sites Tick Register EH
6 EH Food samples chemical analysis
Total number of food samples taken for chemical analysis according to the regulations promulgated in terms of the Foodstuffs, Cosmetics and Disinfectants Act, Act 54 0f 1972
This includes imported food stuffs
Environmental Health
Monthly EHP EH sites Tick Register EH
7 EH Food samples chemically compliant
Number of food samples chemically tested that complied to the Foodstuffs, Cosmetics and Disinfectants Act, Act 54 0f 1972
This includes imported food stuffs
Environmental Health
Monthly EHP EH sites Tick Register EH
8 EH Hazardous substance dealer compliant
Number of the Hazardous Substances dealers inspected that comply with the regulations for hazardous substances
All hazardous substances dealers must be inspected and compliant with Hazardous Substances Act and Regulations
Environmental Health
Monthly EHP EH sites Tick Register EH
9 EH Hazardous substance dealer inspected
The total number of Hazardous Substance dealers inspected
All hazardous substances dealers must be inspected and compliant with Hazardous Substances Act and Regulations
Environmental Health
Monthly EHP EH sites Tick Register EH
Department of Health
Page 49 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Nr Data Element Name Definition Use and context IndGroup Frequency Collected By
Collection Points
Tools
10 EH Health care waste generator compliant
Number of registered health care waste generators inspected that complied with minimum standards according to SANS 10248
All waste generators should be inspected at least once a year. Inspection should be done according to SANS 10248 and any other applicable legislation
Environmental Health
Monthly EHP EH sites Tick Register EH
11 EH Health care waste generator inspected
Total number of registered health care waste generators inspected according to SANS 10248
All waste generators should be inspected at least once a year. Inspection should be done according to SANS 10248 and any other applicable legislation
Environmental Health
Monthly EHP EH sites Tick Register EH
12 EH International conveyance arrival at first point of entry
Total number of international conveyances arrivals at each international point of entry
Environmental Health
Monthly EHP EH sites Tick Register EH
13 EH International conveyance inspected at first point of entry
Number of international conveyances arrivals at each international point of entry inspected in terms of the National Port Health Standard Operating Procedures (revised SOPs)
Environmental Health
Monthly EHP EH sites Tick Register EH
14 EH International imported consignment arrival at point of entry
Total number of international imported consignments arrivals at each international point of entry
Environmental Health
Monthly EHP EH sites Tick Register EH
15 EH International imported consignment inspected
Total number of international imported consignments inspected at each international point of entry in terms of the National Port Health Standard Operating Procedures (revised SOPs) and International Health Regulations (IHR, 2005)
Environmental Health
Monthly EHP EH sites Tick Register EH
16 EH Lead poisoning reported new
Number of new cases of lead poisoning reported to EHP officers
Registered under Act 36 of 1947 Environmental Health
Monthly EHP EH sites Tick Register EH
17 EH Mercury poisoning reported new
Number of new cases of mercury poisoning reported to EHP officers
Registered under Act 36 of 1947 Environmental Health
Monthly EHP EH sites Tick Register EH
18 EH Milling establishment compliant
Number of maize meal/bread flour mill establishments that were inspected and found to comply with the fortification regulation
Regulation promulgated in terms of the Foodstuffs, Cosmetics and Disinfections Act (Act 54 of 1972) and regulations promulgated in terms of the Act
Environmental Health
Monthly EHP EH sites Tick Register EH
Department of Health
Page 50 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Nr Data Element Name Definition Use and context IndGroup Frequency Collected By
Collection Points
Tools
19 EH Milling establishment inspected
Total number of maize meal / bread flour mill establishment that were inspected
Inspected according to regulation promulgated in terms of the Foodstuffs, Cosmetics and Disinfections Act (Act 54 of 1972) and regulations promulgated in terms of the Act
Environmental Health
Monthly EHP EH sites Tick Register EH
20 EH Notifiable medical conditions investigated new
Number of Notifiable medical conditions reported to the District Health Office that were investigated by EHP officers
Only count the first inspection during the financial year. Don't include follow-up inspections
Environmental Health
Monthly EHP EH sites Tick Register EH
21 EH Notifiable medical conditions reported to District Health Office
Total number of Notifiable medical conditions reported to the District Health Office
Only count the first inspection during the financial year. Don't include follow-up inspections
Environmental Health
Monthly EHP EH sites Tick Register EH
22 EH Pesticide poisoning reported new
Number of new cases of pesticide poisoning reported to EHP officers
Registered under Act 36 of 1947 Environmental Health
Monthly EHP EH sites Tick Register EH
23 EH Premises tobacco legislation compliant
Number of premises (as defined in the National Health Act) inspected that comply with Tobacco legislation
Standards set out in the Tobacco Products Control Act, Act 83 of 1993
Environmental Health
Monthly EHP EH sites Tick Register EH
24 EH Premises tobacco legislation inspected
Total number of premises (as defined in the National Health Act) inspected for Tobacco Legislation
Standards set out in the Tobacco Products Control Act, Act 83 of 1993
Environmental Health
Monthly EHP EH sites Tick Register EH
4.3.2 EH Indicators
Nr Indicator Name Typ
e
Annualised
Numerator Denominator Definition Use and context
IndGroup Freq Level Key
reports
1 EH Domestic water sample compliance rate
% 0 EH Domestic water samples compliant
EH Domestic water samples collected
Proportion of routine domestic water samples taken for a Water Services Authority and Non Water Services Authority that conforms to the standards set out in SANS 241
Monitors domestic water safety
Environmental Health
Monthly Process/Activity
2 EH Flour mills compliance rate
% 0 EH Milling establishment compliant
EH Milling establishments inspected
Proportion of operational flour milling establishments that were compliant with regulations
Monitors flour milling establishment compliance
Environmental Health
Monthly Process/Activity
3 EH Food sample bacteriological compliance rate
% 0 EH Food sample bacteriologically compliant
EH Food sample bacteriological analysis
Proportion food samples bacteriologically tested that complied to the Foodstuffs, Cosmetics and Disinfectants Act, Act 54 0f 1972
Monitors food safety. Includes imported food stuffs
Environmental Health
Monthly Process/Activity
Department of Health
Page 51 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Nr Indicator Name Typ
e
Annualised
Numerator Denominator Definition Use and context
IndGroup Freq Level Key
reports
4 EH Food sample chemical compliance rate
% 0 EH Food samples chemically compliant
EH Food samples chemical analysis
Proportion food samples chemically tested that complied to the Foodstuffs, Cosmetics and Disinfectants Act, Act 54 0f 1972
Monitors food safety. Includes imported food stuffs
Environmental Health
Monthly Process/Activity
5
EH Hazardous substance dealers compliance rate
% 0 EH Hazardous substance dealer compliant
EH Hazardous substance dealer inspected
Proportion Hazardous Substances dealers that complied with the regulations for hazardous substances
Monitors hazardous substance dealer compliance
Environmental Health
Monthly Process/Activity
6 EH Health care waste generator compliance rate
% 0 EH Health care waste generator compliant
EH Health care waste generators inspected
Proportion inspected health care waste generators that complied with minimum standards according to SANS 10248
Monitors health care waste generator compliance
Environmental Health
Monthly Process/Activity
7 EH International conveyance inspection rate
% 0
EH International conveyance inspected at first point of entry
EH International conveyance arrivals at first point of entry
Proportion international conveyance at arrival inspected for compliance to International Health standards
Monitors international conveyance inspection
Environmental Health
Monthly Process/Activity
8
EH International imported consignment compliance rate
% 0
EH International imported consignment inspected
EH International imported consignment arrivals at first point of entry
Proportion international imported consignments that complied to International Health standards, compliant in terms of the National Port Health Standard Operating Procedures (revised SOPs) and International Health Regulations (IHR, 2005)
Monitors international imported consignment inspection
Environmental Health
Monthly Process/Activity
9
EH Notifiable disease investigation rate
% 0 EH Notifiable medical conditions investigated new
EH Notifiable medical conditions reported to District Health Office
Proportion Notifiable medical conditions reported to the District Health Office that were investigated by EHP officers
Monitors Notifiable medical condition inspections by EHP officers
Environmental Health
Monthly Process/Activity
10 EH Premises tobacco compliance rate
% 0 EH Premises tobacco legislation compliant
EH Premises tobacco legislation inspected
Proportion inspected premises that were compliant with Tobacco Act
Monitors premises compliant with Tobacco Act
Environmental Health
Monthly Process/Activity
11
EH Reported Food poisoning incidence (annualised)
per100K
1 EH Food poisoning reported new
Population total New cases of food poisoning reported to EHS per 100 000 population
Monitors food poisoning trends
Environmental Health
Monthly Outcome
12
EH Reported lead poisoning incidence (annualised)
per100K
1 EH Lead poisoning reported new
Population total New cases of lead poisoning reported per 100 000 population
Monitors chemical poisoning trends
Environmental Health
Monthly Outcome
Department of Health
Page 52 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Nr Indicator Name Typ
e
Annualised
Numerator Denominator Definition Use and context
IndGroup Freq Level Key
reports
13
EH Reported mercury poisoning incidence (annualised)
per100K
1 EH Mercury poisoning reported new
Population total New cases of mercury poisoning reported per 100 000 population
Monitors chemical poisoning trends
Environmental Health
Monthly Outcome
14
EH Reported pesticide poisoning incidence (annualised)
per100K
1 EH Pesticide poisoning reported new
Population total New cases of pesticide poisoning reported per 100 000 population
Monitors chemical poisoning trends
Environmental Health
Monthly Outcome
4.3.3 EH Validation Rules (extracted from DHIS Jan 2012)
No ValidationRule RoutineDataValidationRuleDescription
1 Domestic water samples collected VS Domestic water samples compliant Domestic water samples collected MUST be greater than or equal to Domestic water samples compliant
2Food samples bacteriological analysis VS Food sample bacteriologically
compliant
Food samples bacteriologically analysed MUST be greater than or equal to Food sample bacteriologically
compliant
3 Food samples chemical analysis VS Food sample chemical compliant Food samples chemically analysed MUST be greater than or equal to Food sample chemically compliant
4Hazardous substance dealer inspected VS Hazardous substance dealer
compliant
Hazardous substance dealer inspected MUST be greater than or equal to Hazardous substance dealer
compliant
5 Health care waste generator inspected VS Health care waste generator compliantHealth care waste generator inspected MUST be greater than or equal to Health care waste generator
compliant
6 International conveyance arrival VS International conveyance inspectedInternational conveyance arrival at first point of entry MUST be greater than or equal to International
conveyance inspected
7International imported consignment arrival VS International imported consignment
inspected
International imported consignment arrival at point of entry MUST be greater than or equal to
International imported consignment inspected at point of entry
8 Milling establishment inspected VS Milling establishment compliant Milling establishment inspected MUST be greater than or equal to Milling establishment compliant
9Notifiable medical conditions reported VS Notifiable medical conditions
investigated
Notifiable medical conditions reported MUST be greater than or equal to Notifiable medical conditions
investigated
10Premises tobacco legislation inspected VS Premises tobacco legislation
compliant
Premises tobacco legislation inspected MUST be greater than or equal to Premises tobacco legislation
compliant
4.3.4 EH Data Tools (examples)
1) DAILY REGISTER: MUNICIPAL ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name: ______________________________________ Month: __________________
DAILY REGISTER: MUNICIPAL ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name: ______________________________________________
EH
Do
me
stic w
ate
r sa
mp
les c
olle
cte
d
EH
Do
me
stic w
ate
r sa
mp
les c
om
plia
nt
EH
He
alth
ca
re w
aste
ge
ne
rato
rs in
sp
ecte
d
EH
He
alth
ca
re w
aste
ge
ne
rato
r co
mp
lia
nt
EH
Le
ad
po
iso
nin
g r
ep
ort
ed
ne
w
EH
Me
rcu
ry p
ois
on
ing
re
po
rte
d n
ew
EH
Pe
sticid
e p
ois
on
ing
re
po
rte
d n
ew
EH
Fo
od
po
iso
nin
g r
ep
ort
ed
ne
w
EH
Fo
od
sa
mp
le b
acte
rio
log
ica
l a
na
lysis
EH
Fo
od
sa
mp
le b
acte
rio
log
ica
lly c
om
plia
nt
EH
Fo
od
sa
mp
les c
he
mic
al a
na
lysis
EH
Fo
od
sa
mp
les c
he
mic
ally c
om
plia
nt
EH
Millin
g e
sta
blish
me
nts
in
sp
ecte
d
EH
Millin
g e
sta
blish
me
nt co
mp
lia
nt
EH
Pre
mis
es to
ba
cco
le
gis
latio
n in
sp
ecte
d
EH
Pre
mis
es to
ba
cco
le
gis
latio
n c
om
plia
nt
EH
No
tifia
ble
me
dic
al co
nd
itio
ns r
ep
ort
ed
to
Dis
tric
t H
ea
lth
Offic
e
EH
No
tifia
ble
me
dic
al co
nd
itio
ns in
ve
stig
ate
d n
ew
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Surveillance
of Premises
Communicable
Diseases
Comment
TOTAL
Food Control
Date __________________________________________________
Reference
Water
Quality
Waste
ManagementChemical Safety
Department of Health
Page 54 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
2) DAILY REGISTER: PROVINCIAL ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name: ___________________________________ Date: _____________________________
DAILY REGISTER: PROVINCIAL ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name: ______________________________________ Date:________________________
EH
Ha
za
rdo
us s
ub
sta
nce
de
ale
r in
sp
ecte
d
EH
Ha
za
rdo
us s
ub
sta
nce
de
ale
r co
mp
lia
nt
EH
He
alth
ca
re w
aste
ge
ne
rato
rs in
sp
ecte
d
EH
He
alth
ca
re w
aste
ge
ne
rato
rs in
sp
ecte
d
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Comment
TOTAL
Waste
Management
Reference
Hazardous
Substances
Department of Health
Page 55 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
3) DAILY REGISTER PORT HEALTH ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name ______________________________________ Date: ___________________
DAILY REGISTER: PORT HEALTH ENVIRONMENTAL HEALTH PRACTITIONER
EHP Name: ______________________________________________Date __________________________________________________E
H D
om
estic w
ate
r sa
mp
les c
olle
cte
d
EH
Do
me
stic w
ate
r sa
mp
les c
om
plia
nt
EH
He
alth
ca
re w
aste
ge
ne
rato
rs in
sp
ecte
d
EH
He
alth
ca
re w
aste
ge
ne
rato
r co
mp
lia
nt
EH
Fo
od
sa
mp
le b
acte
rio
log
ica
l a
na
lysis
EH
Fo
od
sa
mp
le b
acte
rio
log
ica
lly c
om
plia
nt
EH
Fo
od
sa
mp
les c
he
mic
al a
na
lysis
EH
Fo
od
sa
mp
les c
he
mic
ally c
om
plia
nt
EH
Fo
od
po
iso
nin
g r
ep
ort
ed
ne
w
EH
In
tern
atio
na
l co
nve
ya
nce
arr
iva
ls a
t firs
t p
oin
t o
f e
ntr
y
EH
In
tern
atio
na
l co
nve
ya
nce
in
sp
ecte
d a
t firs
t p
oin
t o
f e
ntr
y
EH
In
tern
atio
na
l im
po
rte
d c
on
sig
nm
en
t a
rriv
als
at p
oin
t o
f e
ntr
y
EH
In
tern
atio
na
l im
po
rte
d c
on
sig
nm
en
t in
sp
ecte
d
EH
Pre
mis
es to
ba
cco
le
gis
latio
n in
sp
ecte
d
EH
Pre
mis
es to
ba
cco
le
gis
latio
n c
om
plia
nt
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Comment
TOTAL
Conveyance Control
Reference
Water QualityWaste
ManagementFood Control
Surveillance of
Premises
Department of Health
Page 56 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.3.4.1 EH DHIS Monthly Data Input form
1) Monthly Data Input Form Municipal Health Services
Municipal EHS Area : ____________________________________
Month: _______________________________________________
Completed by:_____________________________ Verified by: ______________________________
No Data Element Value Comment
Water Quality Monitoring
1 EH Domestic water samples collected
2 EH Domestic water samples compliant
Chemical Safety
3 EH Lead poisoning reported new
4 EH Mercury poisoning reported new
5 EH Pesticide poisoning reported new
Food Control
6 EH Food poisoning reported new
7 EH Food sample bacteriological analysis
8 EH Food sample bacteriologically compliant
9 EH Food samples chemical analysis
10 EH Food samples chemically compliant
11 EH Milling establishments inspected
12 EH Milling establishment compliant
Surveillance of Premises
13 EH Premises tobacco legislation inspected
14 EH Premises tobacco legislation compliant
Communicable Diseases
15 EH Notifiable medical conditions reported to District Health Office
16 EH Notifiable medical conditions investigated new
Waste Management
17 EH Health care waste generators inspected
18 EH Health care waste generator compliant
Department of Health
Page 57 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
2) Monthly Data Input Form Provincial Environmental Health Services
Provincial EHS Area___________________________________________
Month:________________________________________________
Completed by:_________________________________ Verified by: __________________________
No Data Element Value Comment
Control of Hazardous Substances
1 EH Hazardous substance dealer inspected
2 EH Hazardous substance dealer compliant
Waste Management
3 EH Health care waste generators inspected
4 EH Health care waster generator complaint
Department of Health
Page 58 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
1) Monthly Data Input Form Port Health Services
Port Name____________________________________ Month: ___________________________
Completed by:_________________________________ Verified by: _________________________
No Data Element Value Comment
Water Quality Monitoring
1 EH Domestic water samples collected
2 EH Domestic water samples compliant
Food Control
3 EH Food sample bacteriological analysis
4 EH Food sample bacteriologically compliant
5 EH Food samples chemical analysis
6 EH Food samples chemically compliant
7 EH Food poisoning reported new
Port Health
8 EH International conveyance arrivals at first point of entry
9 EH International conveyance inspected at first point of entry
10 EH International imported consignment arrivals at point of entry
11 EH International imported consignment inspected
Surveillance of Premises
12 EH Premises tobacco legislation inspected
13 EH Premises tobacco legislation compliant
Waste Management
3 EH Health care waste generators inspected
4 EH Health care waster generator complaint
4.4 Emergency Medical Services Program (EMS)
4.4.1 EMS Data Elements (extracted from DHIS Jan 2012)
Nr Data Element Name Definition Use and context IndGroup Frequency Collected
By Collection
Points Tools
1 EMS call client transported
Number of calls which resulted in any number of clients being transported
Monitors calls which resulted in clients being transported in relation to total calls for which ambulances were dispatched
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
2 EMS calls total Number of calls received by the communications centre
Only count calls for which an ambulance was requested
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
3 EMS inter-facility transfer
Number of clients transferred between health facilities by an ambulance (from one inpatient facility to another inpatient facility)
Monitors use of ambulances for inter-facility transfers
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
4 EMS obstetric client Number of maternity/obstetric clients transported to a health facility
Monitors use of ambulances for transporting maternity/obstetric clients. Include clients transported in Obstetric Emergency Units and those transported in other operational ambulances
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
5 EMS operational ambulances
Actual number of operational ambulances at an ambulance station during the shift
Monitors compliance with norm for operational ambulances. Exclude Obstetric Emergency Units
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
6 EMS operational Obstetric Emergency Units
Number of operational Obstetric Emergency Units at an ambulance station
Monitors compliance with norm for Obstetric Emergency Units
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
7 EMS P1 calls total Total number of P1 calls received by the communication centre
Sum of EMS P1 urban calls and EMS P1 rural calls
EMS Monthly N/A N/A DHIS calculate
8 EMS P1 response under 60 minutes total
Number of P1 calls where the response time was within 60 minutes in both urban and rural areas
Monitors effectiveness of EMS services. Response time is the time it takes an ambulance to reach an emergency medical scene, calculated from the time of the first call to the control room up to the time of arrival on the scene
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
9 EMS P1 rural calls Total number of P1 calls received from rural areas by the communication centre
Monitors P1 EMS needs in rural areas EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
10 EMS P1 rural response under 40 minutes
The number of P1 calls in a rural area where the response time was under 40 minutes
Monitors effectiveness of EMS services in rural areas. Response time is the time it takes an ambulance to reach an emergency medical scene, calculated from the time of the first call to the control room up to the time of arrival on the scene
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
Department of Health
Page 60 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
Nr Data Element Name Definition Use and context IndGroup Frequency Collected
By Collection
Points Tools
11 EMS P1 urban calls Total number of P1 calls received from urban areas by the communication centre
Monitors P1 EMS needs in urban areas EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
12 EMS P1 urban response under 15 minutes
The number of P1 calls in an urban area where the response time was under 15 minutes
Monitors effectiveness of EMS services in urban areas. Response time is the time it takes an ambulance to reach an emergency medical scene, calculated from the time of the first call to the control room up to the time of arrival on the scene
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
13 EMS clients total Total number of clients transported by an ambulance during reporting period
Total number of emergency clients (all priorities) transported by ambulance, irrespective of the number of calls or trips
EMS Monthly EMS Call Centre
EMS Call Centre
Tick Register EMS
Department of Health
Page 61 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.4.2 EMS Indicators (extracted from DHIS Jan 2012)
Nr Indicator
Name Type
Annualised
Numerator Denominator Definition Use and context IndGroup
Freq Level Key
reports
1 EMS call transport rate
% 0 EMS call client transported
EMS calls total Proportion EMS calls which resulted in clients being transported
Monitors the proportion of calls which resulted in clients actually being transported to health facilities in relation to the total number of calls dispatched by the Communications Centre
EMS Monthly Output
2 EMS inter-facility transfer rate
% 0 EMS inter-facility transfer
EMS clients total
Inter-facility (from one inpatient facility to another inpatient facility) transfers as proportion of total EMS clients transported
Monitors use of ambulances for inter-facility transfers as opposed to emergency responses
EMS Monthly Output
3 EMS obstetric client transport rate
% 0 EMS obstetric client
EMS clients total Obstetric clients as proportion of total EMS clients transported
Monitors need for and use of ambulances for obstetric clients. Includes obstetric clients transported in obstetric and other operational ambulances
EMS Monthly Output
4
EMS operational ambulance coverage (annualised)
per10K
1 EMS operational ambulances
Population total Number of operational ambulances per 10 000 population
Monitors compliance with the norm for operational ambulances to meet population needs. This includes obstetric ambulances
EMS Monthly Input
5
EMS operational Obstetric Emergency Unit coverage
% 0
EMS operational Obstetric Emergency Units
Population total
The number of operational obstetric units available for transporting obstetric cases per 10,000 population
Count only operational obstetric units. Exclude normal operational ambulances
EMS Monthly Input
6 EMS P1 call response under 60 minutes rate
% 0 EMS P1 response under 60 minutes
EMS P1 calls total
Proportion of all P1 calls with response times under 60 minutes
Monitors compliance with the norm for all critically ill or injured clients to receive EMS within 60 minutes. This includes P1 urban responses under 15 minutes and P1 rural calls under 40 minutes. Low rates indicate inadequate resources
EMS Monthly Output
7 EMS P1 rural response under 40 minutes rate
% 0 EMS P1 rural response under 40 minutes
EMS P1 rural calls
Proportion P1 calls in rural locations with response times under 40 minutes
Monitors compliance with the norm for critically ill or injured clients to receive EMS within 40 minutes in rural areas
EMS Monthly Output
8 EMS P1 urban response under 15 minutes rate
% 0 EMS P1 urban response under 15 minutes
EMS P1 urban calls
Proportion P1 calls in urban locations with response times under 15 minutes
Monitors compliance with the norm for critically ill or injured clients to receive EMS within 15 minutes in urban areas
EMS Monthly Output
4.4.3 EMS Data Tools
4.4.3.1 EMS Individual patient record / data collection tool
Department of Health
Page 63 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.4.3.2 EMS Tick Sheet / Register
Date Name / number Sex Age
EM
S c
all
clie
nt tr
ansport
ed
EM
S c
alls
tota
l
EM
S in
ter-
facility
tra
nsfe
r
EM
S o
bste
tric
clie
nt
EM
S o
pera
tional a
mbula
nces
EM
S o
pera
tional O
bste
tric
Em
erg
ency U
nits
EM
S P
1 c
alls
tota
l
EM
S P
1 r
esponse u
nder
60 m
inute
s tota
l
EM
S P
1 r
ura
l calls
EM
S P
1 r
ura
l response u
nder
40 m
inute
s
EM
S P
1 u
rban c
alls
EM
S P
1 u
rban r
esponse u
nder
15 m
inute
s
EM
S c
lients
tota
l
RUNNING TOTAL
TOTAL
MonthStation Name
Department of Health
Page 64 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.4.3.3 EMS DHIS Monthly Data Input form (DHIS auto-generated)
EMS Station Month
Completer by Date
Verified by Date
Checked by (Station Manager) Date
Captured by Date
SortOrder DataElement Value Comment
1 EMS call client transported
2 EMS calls total
3 EMS inter-facility transfer
4 EMS obstetric client
5 EMS operational ambulances
6 EMS operational Obstetric Emergency Units
7 EMS P1 calls total
8 EMS P1 response under 60 minutes total
9 EMS P1 rural calls
10 EMS P1 rural response under 40 minutes
11 EMS P1 urban calls
12 EMS P1 urban response under 15 minutes
13 EMS clients total
Department of Health
Page 65 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.5 Maintain the Organisational Hierarchy of NON-FACILITY DHIS data files
The provincial and district Information officers are responsible for managing the Organisational Hierarchy in the DHIS data files.
4.5.1 Organisational Hierarchy Integrated School Health Program (ISHP) data file
ISHP data is captured by School at OrgUnit 5 level
If a School is captured where the name is not on the DHIS list, the Information Officer must contact the Department of Education.
4.5.2 Organisational Hierarchy Environmental Health (EH) data file
EH data is captured at OrgUnit 5 level.
4.5.3 Organisational Hierarchy Emergency Medical Services (EMS) data file/set
EMS data is captured at OrgUnit 5 level
4.5.4 Organisational Hierarchy – Ward Based Outreach Team (WBOT) data file
PHC Outreach Teams have to use a more complex Organisational Hierarchy for reporting than normal health facilities for at least two reasons:
1. The routinely collected data must relate to the community, which in this case means each of the
current political wards in the country.
2. The same data and the teams must also relate to the “parent facility” of each team, both because
the outreach teams are managed via these facilities and because the households and individuals
covered receive health services from these facilities.
Department of Health
Page 66 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
OrgUnit Level
Description
OrgUnit
1-5
These Organisational Unit levels are the standard ones used for normal monthly and quarterly reporting from health facilities: National (OU 1), Province (OU 2), Health District (OU 3), Health Sub-district (OU 4), and Health Facility (OU 5). The naming convention for these OU1-OU5 OrgUnits is the same as for all other DHIS data files containing facility data.
OrgUnit 6
The currently (2012) 4,277 political wards in the country form the Organisational Units at level 6. Each ward must be linked to a “parent” PHC health facility within the same health sub-district, preferablye the health facility that provide the bulk of health services to the population in the ward. The closest or largest fixed PHC health facility in the within or in the vicinity of each ward has initially been allocated as the parent facility for each ward in the DHIS. Local managers must review this initial allocation and move the ward to a more suitable “parent” PHC facility where required.
The naming convention for political wards follows the format
<Prov Prefix> <Health sub-District Name> <Ward><Ward Number “0xx”>
Examples: Ward 7 in the City of Johannesburg is “gp City of Johannesburg Ward 007” and ward 112 is “gp City of Johannesburg Ward 112” (always use 3 characters for the ward number).
OrgUnit
7
The activities of each outreach team active in a ward forms the reporting unit at level 7. Note that one reporting unit is only directly equivalent to one outreach team if that outreach team work only in one ward. It is important to understand that
There might be several outreach teams working in the larger wards (i.e. several reporting
units)
One outreach team might work in several (usually smaller) wards (i.e. several reporting units)
While not recommended, there might be cases where an Outreach Team linked to a health
facility in health sub-district A assist with the work in a ward in the neighbouring sub-district B.
Such reporting units must reside under that ward in sub-district B. In the highly unlikely event
that one team is operating in two wards from different sub-districts with the same ward
number, then name those reporting units by adding an “a” or “b” at the end of the name.
The primary analysis of Ward Based Outreach Team activities and health data will be per ward and then geographically aggregated to sub-district, district, province, and national. The DHIS has nevertheless also been configured to enable aggregation of data via the “parent” facility of each outreach team, since that often will be relevant for monitoring the Ward Based Outreach Team roll-out across the country.
The naming convention for Ward Based Outreach Team reporting units follows the format
<Prov Prefix> <Parent Health Facility> <- W><Ward Number “0xx”>
Example: The first Outreach Team at the Stanza Bopape II Clinic in the City of Tshwane are working in Ward 20, 27, and 97, whereas the second team is working in Ward 98. Four reporting units are created:
gp Stanza Bopape II Clinic Outreach Team 1 - W020, child OU under Tshwane Ward 020
gp Stanza Bopape II Clinic Outreach Team 1 - W097, child OU under Tshwane Ward 097
gp Stanza Bopape II Clinic Outreach Team 1 - W099, child OU under Tshwane Ward 099
gp Stanza Bopape II Clinic Outreach Team 2 - W098, child OU under Tshwane Ward 098
It is important that all reporting units under a specific facility have identical names except for the team and ward numbers, since that part of the name will be used to group reporting units in accordance with the PHC facility that the teams are operating from.
Department of Health
Page 67 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.5.4.1 Managing and Expanding the WBOT Organisational Hierarchy
When establishing Ward Based Outreach Teams, district and sub-district management teams should consider several aspects that will make long term data management easier:
Each ward should have as many Outreach Teams as required by the current number of
households, and preferably not more – avoid dividing up a ward among many teams if possible,
and even if such fragmentation might have a few logistical/transport benefits.
Avoid cross-sub-district-border Outreach Teams if possible.
Temporary allocations of Outreach Teams to wards might be particularly tempting during the
initial build-up of the Ward Based Outreach Team structure, but should be avoided if possible.
Significant shifts over time in which teams work where, will either result in a significant number of
closed reporting units with data for only a few months or years, or calls for moving data between
teams (mergers etc).
Ensure that all new Outreach Teams being established are clearly defined in terms of (a) the ward
or wards they will work in and how many households allocated to each team; (b) the “parent” PHC
facility they are attached to; and (c) any other semi-permanent data about the team required for
processing indicators or monitoring the roll-out.
4.5.4.2 Updating the Primary Health Facility “Parent” for each Political Ward
All districts and sub-districts must as soon as possible review the preliminary allocation of political wards to their “primary PHC service provider” facility done by the National Department of Health. This preliminary allocation was based on the following (except for a few cases where Outreach Teams had been established already):
If one or more fixed PHC facilities were located within the borders of the ward, the largest such
facility was selected as the “parent” health facility for that ward.
If there were no fixed PHC facility within the ward, then select the largest and/or “dominant” fixed
PHC facility located in any of the surrounding wards.
In order to correct this child-parent relationship between the ward and its primary service provider in the DHIS, go to Maintenance and then Organisational Hierarchy. Select the relevant ward, and use the MOVE function to place it under the correct health facility within the geographically correct health sub-district.
Note again that allocating wards to health facilities in other sub-districts are prohibited. Even if one or more wards end up being serviced by Outreach Teams from neighbouring sub-districts, and even if the population in that/those wards predominantly used health facilities from neighbouring sub-districts – such wards must use a health facility located in the correct sub-district as a “parent”.
Political wards are in general demarcated by the Municipal Demarcation Board, with revisions before every local election. Modifications to the WBOT data file related to such national revisions from the Municipal Demarcation Board will be co-ordinated by the National Department of Health.
In the exceptional event that wards are created or modified in between these election cycles, the District Manager is responsible for ensuring that the WBOT reporting and the DHIS OrgHierarchy is updated accordingly and that the province and national are informed.
The primary PHC health facility “parent” for a ward might change over time, for instance due to the sub-district re-organising its services or due to a new health facility opening. If that is the case, simply MOVE the relevant ward to its new facility “parent”, and all existing data will be moved along with it.
Department of Health
Page 68 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.5.4.3 Adding or Modifying Ward Based Outreach Team Reporting Units
The DHIS WBOT data file will be disseminated with a few hundred Outreach Team reporting units included, and some of these might be incorrect in terms of the ward or in terms of which facility the team is related to. Verify the level 7 reporting units for your area before you start capturing data.
The number of teams is expected to expand rapidly over the next 2-3 years, with an expected total of around 6,500 teams active when the re-engineered PHC system is fully operational. This means on average around 1.5 teams for each political ward.
When a new team has been established or started in a ward, then create a new reporting unit at level 7 under that ward, naming it as described above (fixed PHC facility name + team number under that facility + ward number):
Add the new Reporting Unit to the DHIS under Maintenance -> Organisational Hierarchy, set the
correct start data (note: always use the first day of the start-up month), and tick the “Submit data”
tick-box. Follow the established naming convention also for the short version of the name. If
“standard” short names end up being over 25 characters when the “Outreach Team X” and
“W0xx” are added, then use common sense to shorten the first “facility” part of the name and
make sure all reporting units linked to that facility have short names constructed in an identical
manner.
Add the Reporting Unit’s Organisational Code if available from the district management team
Use “Ward Based Outreach Team” for OrgUnitType
Use “Province Outreach Team” or “Municipality Outreach Team” or “NGO Outreach Team” for
OrgUnitOwnerShip
Use “Rural” or “Urban” or “Peri-Urban” for OrgUnitRuralUrban
A Ward Based Outreach Team reporting unit and its data are primarily linked to the ward, so the normal response to a specific team ceasing activity in a ward would be to CLOSE that reporting unit. Remember then that the closing date should be the last day of the last reporting month, and that the “Submits data” tick-box should be un-ticked.
When a specific team changes the PHC facility it is affiliated with, but otherwise continue its activities in the same ward as before, then each of the relevant WBOT reporting units should be RENAMED so the reporting unit names reflect its affiliated PHC facility name.
4.5.5 The PHC WBOT Household Profile Data File
A separate DHIS data file has been created to capture and store the data from the Household Profile/Registration forms collected during the initial visit to each household, and possibly later updated.
As the Organisational Hierarchy is the main WBOT data file is updated and maintained as outlined above, the same changes should be done to the Household Profile data file (which runs under the DHIS Patient Module).
The PHC WBOT Household Profile Data File will be rolled out for implementation at a later stage
Department of Health
Page 69 of 69
Standard Operating Procedure for District Health Information System
(DHIS) Management: Facility level
4.5.6 Adding Local Data Elements and Indicators
For the large majority of Ward Based Outreach Teams that work according to the national guidelines for such teams, adding local data elements or indicators are strongly discouraged during the initial roll-out of the WBOT system.
In districts or areas that have opted for an expanded mandate that includes additional services during household visits, it might be necessary to add local data elements and indicators. This should be done as follows:
Add the additional data elements and indicators as required (see other sections of the SOP and
the DHIS user manual for how to do this)
Create a new local data set that contain all national data elements plus the local ones – do not
modify the national WBOT data set.
Clarify with the district and with the province if they want such local data elements / data
submitted. If yes, use the extended “WBOT Local” data set for export. If no, use the standard
WBOT data set for export to higher levels.
________________________________________________________________________