Session 6 – The health facilities and operational districts master lists for Cambodia Sokna Sek – MOH/DPHI Leng Ing – MOH/DPHI Sat Chab – MOH/DPHI Steeve Ebener – HGLC Izay Pantanilla – HGLC

Master lists core to public health in Cambodia 4 main geographic objects Administrative divisions (Provinces, Districts, communes) Villages Ministry of Interior Health facilities Operational Districts A master list is needed for each of these objects Ministry of Health 2

Master lists core to public health in Cambodia https://www.healthgeolab.net/MEETINGS/CGR_2017/Geo-Registriy_Workshop_Final_Exec_Sum_010717.pdf 3

The health facilities master list for Cambodia Session 6 – The health facilities master list for Cambodia Sokna Sek – MOH/DPHI Leng Ing – MOH/DPHI Sat Chap – MOH/DPHI Steeve Ebener – HGLC Izay Pantanilla – HGLC

Health facilities master list content What is an health facility? Few examples of definition: Medline Plus: Places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, such as birthing centers and psychiatric care centers. Health authority Abu Dhabi: Standalone building with inpatient services for 24 hours use or longer by patients in the treatment of diseases, injuries, deformities, abnormal physical or mental status, maternity cases, nurseries and dispensaries. Free dictionary: Building where medicine is practiced. DOH Philippines: A building or physical structure providing health care. Wikipedia: in general, any location at which medicine is practiced regularly. Importance of the geography (location, place,..) Need to clarify few terms (health care, medicine,…)

Health facilities master list content What is an health facility? Additional definition: Health services (WHO): Health services include all services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of health. They include personal and non-personal health services. Health care (Wikipedia): Diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings Medicine (Collins English Dictionary): the science of preventing, diagnosing, alleviating, or curing disease Infrastructures included in the master list depend on the definition Pharmacies and mobile clinics would not be included here for example The definition used by the MOH in Cambodia: “A building or permanent physical structure where health care is being provided”

Health facilities master list content The signature domain (2007)1 Good practice would be to have only one coding scheme Actually needs to be captured for each field together with the source Direct link with the administrative divisions registry Core fields allowing to uniquely identify, define, locate and contact each facility Looked at these elements in relation to the current content of the health facility master list 1 http://www.measureevaluation.org/resources/publications/wp-07-91

Health facilities master list content Uniquely identifying each facility Rules to choose an appropriate coding scheme 1. Ensure for the code schemes to be meaningless, meaning not to embed codes or other semantic meaning that could change through time in an identifier (e.g., admin division code, health facility type, etc.). Tororo hospital: UGA993001 Do not include other “objects” in your coding scheme Capture these “objects” as separated fields in your master list

Health facilities master list content Uniquely identifying each facility Rules to choose an appropriate coding scheme 2. Use a sequence as short as possible but taking into account the number of changes that could take place over the coming decades (function of the current number of health facilities observed in the country) Avoid long codes 148337353801198976578393 3. Using a check digit, such as the luhn algorithm (e.g., 1000001-3) or a specific set of characters at the beginning of the sequence (e.g. “HF”) to avoid the problems linked to having a “0” in front of it 08365222 The “0” disappears in some software starting with excel 4. Having the ID generated sequentially. (e.g., 100001, 100002, 100003,... or HF00001, HF00002, HF0003,...) 5. The code remains the same from the opening until the closing of the facility and this even if its name, type (upgrade) or location changes (practice not always followed right now

Health facilities master list content Uniquely identifying each facility Coding scheme currently used in Cambodia Province OD Health facility 09 01 10 090110 The administrative division or OD in which the facility is located can change. Two options when there is a change Change the code: Loose the continuity in the database (seen in the current list and has created duplicates) Keep the code: Loose the code meaning The « 0 » in front can fall depending on the software you use (e.g. excel)

Health facilities master list content Uniquely identifying each facility New coding scheme to be implemented in the master list HF000001 Main advantages of this scheme: Meaningless . Any information to change through time is stored in the master list Avoid the problem of the “0” in front of the sequence and allow for the sequence to remain the same across software Allows for the platform serving as common geo-registry to automatically generate the code (by incrementation) Short enough to avoid data entry mistakes while allowing for enough facilities to be created over more than 600 years Allows the use of the code beyond the health sector

Health facilities master list content Uniquely identifying each facility All the other information are stored in the master list and past values are kept in the system 2017 2010 2005 + can create « geo-tags » on the fly directly from the master list. For example: Province OD Health facility Not a unique ID, just an information! 01 HF000001 0101HF000001

Health facilities master list content Uniquely identifying each facility Official Health Facility Name Good practice: in English and in Khmer Include the name of the facility in full Include the health facility type to avoid names duplicates Might have to adjust the name in Khmer to capture the type Capture past facility names

Health facilities master list content Define each facility Health facility type Type of the health facility based on the official classification used in the country Currently available for public health facilities managed by the MOH Needs to be completed for the private and the other governmental health facilities (MOI, MOND)

Health facilities master list content Define each facility Ownership or managing authority Major classification: Government, Private The master list only includes governmental health facilities managed by the MOH for the moment Sub-classification to be defined for both Government: MOH, MOI, MOND Private: Single Proprietorship; Partnership; Corporation; Corporation; Cooperative; Foundation; Religious; Non-government Organization

Health facilities master list content Locate each facility Address Street number and name (when it applies) Eventually the zip code if useful Location in the administrative structure Official code and name of the Province, District and Commune in which the health facility is located as per the NDCC gazetteer Ideally, official code and name of the village in which the health facility is located Information to be completed for a significant number of health facilities + The administrative structure of the country also evolve through time Requires for an official master list of administrative divisions and villages that is regularly updated http://db.ncdd.gov.kh/gazetteer/view/index.castle

Health facilities master list content Locate each facility Geographic coordinates Latitude and longitude of the health facility expressed in decimal degrees together with the indication of the source, method and accuracy level attached to the coordinates (a separate field for each information) Longitude: ###.##### Latitude ##.##### Example for Myanmar Accuracy of the geographic coordinates currently in the master list is unknown and remains to be improved Reason for the session and exercise in day 1

Health facilities master list content Contact each facility Information needed to contact the health facility through different media including but not limited to the full name and position of the health facility head as well as the phone numbers (mobile, landline) and email address (to be captured in separated fields). Information to be completed in the master list Other important information to capture Health facility opening date Health facility closing date (when applicable) Operational status (active, inactive) … Information to be completed in the master list The PHDs have an important role to play to establish and regularly update the master list

Health facilities master list content Data dictionary Defines what is recognized as the official source for each of the field Attaches a source and time stamp (start validity date) to each field for quality and monitoring 50 fields currently in the data dictionary

The operational districts master list for Cambodia Session 6 – The operational districts master list for Cambodia Sokna Sek – MOH/DPHI Leng Ing – MOH/DPHI Sat Chap – MOH/DPHI Steeve Ebener – HGLC Izay Pantanilla – HGLC

Operational districts master list Origin and history System established in 1995 By the MOH as part of the Health Coverage Plan to organize and deliver government health services The number of OD has been growing rapidly since then.. 1995 … 2010 2014 2015 2016 2017 ~60 76 80 81 93 99-100 Unfortunately the MOH did not keep track of the changes that occurred since 1995

Operational districts master list Content Start validity date Simpler content than the content of the health facility master list. OD: operation district different from administration district, it’s cover 1 or 2 admin district and cover pop. From 60.000 to 200.000 pop. Province code and name OD code and name

Operational districts master list content Uniquely identifying each operational district Coding scheme currently used in Cambodia Province Operational district 01 0101 Issues linked to the current scheme The « 0 » in front can fall depending on the software you use (e.g. excel) The use of « 25 » for the National hospital => conflict with the 25th Province

Operational districts master list content Uniquely identifying each operational district New proposed coding scheme Object type Province Operational district OD 01 OD0101 Main advantages of this scheme: Same ones as those listed for the proposed new health facility coding scheme (meaningless, “0”, short enough, use beyond the health sector Issue being addressed as part of the HIS geo-enabling process

Operational districts master list content Building the historic changes Exercise later today