Using mobile solutions to improve quality of data reported by Primary Health Care centers: Lessons from the DHIS mobile pilot in Nigeria By Francis Agbo National Agency for the Control of AIDS, Nigeria

Background Nigeria adopted the District Health Information System (DHIS) as the platform for the National Health Management Information System (NHMIS) in The national HIV/AIDS response in Nigeria commenced the use of cloud based DHIS for data reporting in phased implementation The first phase is the DHIS web client using computers and targeting states, Local Government Areas, secondary and tertiary health facilities. The second phase is the DHIS mobile client using mobile phones targeting primary health care (PHC) facilities where ICT infrastructure such as computers and direct internet access is not readily available.

Methods Desk review and consultations with technical experts and key stakeholders Phone specifications agreed- Nokia Asha 200 dual SIM phone Customization of the harmonized NHMIS monthly summary form on phones. Field test of the application in 4 PHCs. 80 Global Fund supported PHCs providing HIV services in 16 states were randomly selected for the pilot phase. PHC staff trained to use the DHIS mobile application in October 2013 and commenced using the application for reporting data monthly. Timeliness and completeness of data reported on the DHIS platform three months before and three months after introduction of the DHIS mobile phone application was then analyzed.

Results Low cost- NGN4/USD0.025cents to send data monthly, no travel cost to take data to the LGA Simple and easy to use Overall timeliness of reported data doubled from 32% before introduction of the DHIS mobile apps to 63% after. Timeliness improved in all 16 states in the pilot with the use of the application. Three states witnessed a six and half fold improvement in data timeliness while two states witnessed a three and a half fold improvement. Overall level of data completeness was 46% before introduction of the application and 68% after. Data completeness increased in 88 % of the 16 states. Data completeness increased six fold in one state, three folds in two states and two and half fold in one state respectively.

Lessons learned & Next steps A simple low cost mobile phone application can improve timeliness and completeness of routine health data reported by PHCs in Nigeria. In itself the application is not a “silver bullet”. Needs to be complimented with dedicated data entry clerks, supervision, data quality checks as well as supporting data producers to use the data. Sustainability- trained data entry clerks, partnership with GSM service providers.- PCRP Scale up to an additional 1520 PHCs in 2014 and up to 5000 PHCs in PCRP

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